Pharmaceutical salts of macrocyclic modulators of the ghrelin receptor

ABSTRACT

The present invention provides novel conformationally-defined macrocyclic compounds that have been demonstrated to be selective modulators of the ghrelin receptor (growth hormone secretagogue receptor, GHS-R1a and subtypes, isoforms and variants thereof). Methods of synthesizing the novel compounds are also described herein. These compounds are useful as agonists of the ghrelin receptor and as medicaments for treatment and prevention of a range of medical conditions including, but not limited to, metabolic and/or endocrine disorders, gastrointestinal disorders, cardiovascular disorders, obesity and obesity-associated disorders, central nervous system disorders, genetic disorders, hyperproliferative disorders and inflammatory disorders.

RELATED APPLICATION INFORMATION

This application is a continuation under 35 U.S.C. §120 of U.S. patentapplication Ser. No. 11/149,731, filed Jun. 10, 2005, now U.S. Pat. No.7,476,653, issued Jan. 13, 2009, which claims the benefit under 35U.S.C. §120 of U.S. patent application Ser. No. 10/872,142, filed Jun.18, 2004, now U.S. Pat. No. 7,521,420, issued Apr. 21, 2009, whichclaims the benefit under 35 U.S.C. §119(e) of U.S. Provisional PatentApplication Ser. No. 60/479,223, filed Jun. 18, 2003. This continuationapplication also claims the benefit under 35 U.S.C. §119(e) of U.S.Provisional Patent Application Ser. No. 60/621,642, filed Oct. 26, 2004,U.S. Provisional Patent Application Ser. No. 60/622,005, filed Oct. 27,2004, and U.S. Provisional Patent Application Ser. No. 60/642,271, filedJan. 7, 2005. The disclosures of the above-referenced applications areincorporated herein by reference in their entireties.

FIELD OF THE INVENTION

The present invention relates to novel conformationally-definedmacrocyclic compounds that bind to and/or are functional modulators ofthe ghrelin (growth hormone secretagogue) receptor including GHS-R1a andsubtypes, isoforms and/or variants thereof. The present invention alsorelates to intermediates of these compounds, pharmaceutical compositionscontaining these compounds and methods of using the compounds. Thesenovel macrocyclic compounds are useful as therapeutics for a range ofdisease indications. In particular, these compounds are useful fortreatment and prevention of gastrointestinal disorders including, butnot limited to, post-operative ileus, gastroparesis, including diabeticgastroparesis, opioid bowel dysfunction, chronic intestinalpseudo-obstruction, short bowel syndrome and functional gastrointestinaldisorders.

BACKGROUND OF THE INVENTION

The improved understanding of various physiological regulatory pathwaysenabled through the research efforts in genomics and proteomics hasbegun to impact the discovery of novel pharmaceutical agents. Inparticular, the identification of key receptors and their endogenousligands has created new opportunities for exploitation of thesereceptor/ligand pairs as therapeutic targets. For example, ghrelin is arecently characterized 28-amino acid peptide hormone isolated originallyfrom the stomach of rats with the orthologue subsequently identified inhumans. (Kojima, M.; Hosoda, H. et al. Nature 1999, 402, 656-660.) Theexistence of this peptide in a range of other species suggests aconserved and important role in normal body function. This peptide hasbeen demonstrated to be the endogenous ligand for a previously orphan Gprotein-coupled receptor (GPCR), type 1 growth hormone secretatoguereceptor (hGHS-R1a) (Howard, A. D.; Feighner, S. D.; et al. A receptorin pituitary and hypothalamus that functions in growth hormone release.Science 1996, 273, 974-977.) found predominantly in the brain (arcuatenucleus and ventromedial nucleus in the hypothalamus, hippocampus andsubstantia nigra) and pituitary. (U.S. Pat. No. 6,242,199; Intl. Pat.Appl. Nos. WO 97/21730 and WO 97/22004) The receptor has also beendetected in other areas of the central nervous system (CNS) and inperipheral tissues, for instance adrenal and thyroid glands, heart,lung, kidney, and skeletal muscles. This receptor was identified andcloned prior to the isolation and characterization of the endogenouspeptide ligand and is distinct from other receptors: involved in theregulation of growth hormone (GH) secretion, in particular, the growthhormone-releasing hormone (GHRH) receptor.

A unique characteristic of both the rat and human peptides is thepresence of the n-octanoyl (Oct) moiety on Ser³. However, the des-acylform predominates in circulation, with approximately 90% of the hormonein this form. This group is derived from a post-translationalmodification and appears relevant for bioactivity and possibly also fortransport into the CNS. (Banks, W. A.; Tschöp, M.; Robinson, S. M.;Heiman, M. L. Extent and direction of ghrelin transport across theblood-brain barrier is determined by its unique primary structure. J.Pharmacol. Exp. Ther. 2002, 302, 822-827.) In a GH-releasing assay, thedes-octanoyl form of the hormone was at least 100-fold less potent thanthe parent peptide, although it has been suggested that the des-acylspecies may be responsible for some of the other biological effectsassociated with ghrelin. This des-acyl form has also been postulated tobe primarily responsible for the cardiovascular and cell proliferationeffects attributed to ghrelin, while the acylated form participates inmaintenance of energy balance and growth hormone release. (Baldanzi, G.,Filighenddu, N.; Cutrupi, S.; et al. Ghrelin and des-acyl ghrelininhibit cell death in cardiomyocytes and endothelial cells throughERK1/2 and PI-3 kinase/AKT. J. Cell Biol. 2002, 159, 1029-1037)Similarly, des-Gln¹⁴-ghrelin and its octanoylated derivative have beenisolated as endogenous forms of the hormone arising from alternativesplicing of the ghrelin gene, but both are found to be inactive instimulating GH release in vivo. (Hosoda, H.; Kojima, M.; Matsuo, H.;Kangawa, K. Purification and characterization of rat des-Gln¹⁴-ghrelin,a second endogenous ligand for the growth hormone secretagogue receptor.J. Biol. Chem. 2000, 275, 21995-2120.). Other minor forms of ghrelinproduced by post-translational processing have been observed in plasma,although no specific activity has been attributed to them. (Hosoda, H.;Kojima, M.; et al. Structural divergence of human ghrelin.Identification of multiple ghrelin-derived molecules produced bypost-translational processing. J. Biol. Chem. 2003, 278, 64-70.)

Even prior to the isolation of this receptor and its endogenous peptideligand, a significant amount of research was devoted to finding agentsthat can stimulate GH secretion. The proper regulation of human GH hassignificance not only for proper body growth, but also a range of othercritical physiological effects. Since GH and other GH-stimulatingpeptides, such as GHRH and growth hormone releasing factor (GRF), aswell as their derivatives and analogues, are administered via injection,to better take advantage of these positive effects, attention wasfocused on the development of orally active therapeutic agents thatwould increase GH secretion, termed GH secretagogues (GHS).Additionally, use of these agents was expected to more closely mimic thepulsatile physiological release of GH.

Beginning with the identification of the growth hormone-releasingpeptides (GHRP) in the late 1970's, (Bowers, C. Y. Growthhormone-releasing peptides: physiology and clinical applications. Curr.Opin. Endocrinol. Diabetes 2000, 7, 168-174; Camanni, F.; Ghigo, E.;Arvat, E. Growth hormone-releasing peptides and their analogs. Front.Neurosci. 1998, 19, 47-72; Locatelli, V.; Torsello, A. Growth hormonesecretagogues: focus on the growth hormone-releasing peptides.Pharmacol. Res. 1997, 36, 415-423.) a host of agents have been studiedfor their potential to act as GHS. In addition to their stimulation ofGH release and concomitant positive effects in that regard, GHS wereprojected to have utility in the treatment of a variety of otherdisorders, including wasting conditions (cachexia) as seen in HIVpatients and cancer-induced anorexia, musculoskeletal frailty in theelderly, and growth hormone deficient diseases. Many efforts over thepast 25 years have yielded a number of potent, orally available GHS.(Smith, R. G.; Sun, Y. X.; Beatancourt, L.; Asnicar, M. Growth hormonesecretagogues: prospects and pitfalls. Best Pract. Res. Clin.Endocrinol. Metab. 2004, 18, 333-347; Fehrentz, J.-A.; Martinez, J.;Boeglin, D.; Guerlavais, V.; Deghenghi, R. Growth hormone secretagogues:Past, present and future. IDrugs 2002, 5, 804-814; Svensson, J. Exp.Opin. Ther. Patents 2000, 10, 1071-1080; Nargund, R. P.; Patchett, A.A.; et al. Peptidomimetic growth hormone secretagogues. Designconsiderations and therapeutic potential. J. Med. Chem. 1998, 41,3103-3127; Ghigo, E; Arvat, E.; Camanni, F. Orally active growth hormonesecretagogues: state of the art and clinical perspective. Ann. Med.1998, 30, 159-168; Smith, R. G.; Van der Ploeg, L. H. T.; Howard, A. D.;Feighner, S. D.; et al. Peptidomimetic regulation of growth hormonesecretion. Endocr. Rev. 1997, 18, 621-645.) These include smallpeptides, such as hexarelin (Zentaris) and ipamorelin (Novo Nordisk),and adenosine analogues, as well as small molecules such as carpomorelin(Pfizer), L-252,564 (Merck), MK-0677 (Merck), NN703 (Novo Nordisk),G-7203 (Genentech), S-37435 (Kaken) and SM-130868 (Sumitomo), designedto be orally active for the stimulation of growth hormone. However,clinical testing with such agents have rendered disappointing resultsdue to, among other things, lack of efficacy over prolonged treatment orundesired side effects, including irreversible inhibition of cytochromeP450 enzymes (Zdravkovic M.; Olse, A. K.; Christiansen, T.; et al. Eur.J. Clin. Pharmacol. 2003, 58, 683-688.) Therefore, there remains a needfor pharmacological agents that could effectively target this receptorfor therapeutic action.

Despite its involvement in GH modulation, ghrelin is primarilysynthesized in the oxyntic gland of the stomach, although it is alsoproduced in lesser amounts in other organs, including the kidney,pancreas and hypothalamus. (Kojima, M.; Hsoda, H.; Kangawa, K.Purification and distribution of ghrelin: the natural endogenous ligandfor the growth hormone secretagogue receptor. Horm. Res. 2001, 56(Suppl. 1), 93-97; Ariyasu, H.; Takaya, K.; Tagami, T.; et al. Stomachis a major source of circulating ghrelin, and feeding state determinesplasma ghrelin-like immunoreactivity levels in humans. J. Clin.Endocrinol. Metab. 2001, 86, 4753-4758) In addition to its role instimulating GH release, the hormone has a variety of other endocrine andnon-endocrine functions (Broglio, F.; Gottero, C.; Arvat, E.; Ghigo, E.Endocrine and non-endocrine actions of ghrelin. Horm. Res. 2003, 59,109-117) and has been shown to interact with a number of other systemsin playing a role in maintaining proper energy balance. (Horvath, T. L.;Diano, S.; Sotonyi, P.; Heiman, M.; Tschop, M. Ghrelin and theregulation of energy balance—a hypothalamic perspective. Endocrinology2001, 142, 4163-4169; Casanueva, F. F.; Dieguez, C. Ghrelin: the linkconnecting growth with metabolism and energy homeostasis. Rev.Endocrinol. Metab. Disord. 2002, 3, 325-338). In particular, the peptideghrelin plays a role as an orexigenic signal in the control of feeding,in which it acts to counteract the effects of leptin. Indeed, it was thefirst gut peptide proven to have such orexigenic properties. (Kojima,M.; Kangawa, K. Ghrelin, an orexigenic signaling molecule from thegastrointestinal tract. Curr. Opin. Pharmacology 2002, 2, 665-668.) Thehormone also is implicated in the hypothalamic regulation of thesynthesis and secretion of a number of other neuropeptides involved inappetite and feeding behavior. Levels of ghrelin are elevated inresponse to fasting or extended food restriction. (Nakazato, M.;Murakami, N.; Date, Y.; Kojima, M.; et al. A role for ghrelin in thecentral regulation of feeding. Nature 2001, 409, 194-198) For example,subjects suffering with anorexia or bulimia exhibit elevated ghrelinlevels. Circulating levels of the hormone have been found to rise beforemeals and fall after meals. In addition, diet-induced weight loss leadsto increased ghrelin levels, although obese subjects who have gastricbypass surgery do not likewise experience such an increase. (Cummings,D. E.; Weigle, D. S.; Frayo, R. S.; et al. Plasma ghrelin levels afterdiet-induced weight loss or gastric bypass surgery. N. Engl. J. Med.2002, 346, 1623-1630)

This intimate involvement of ghrelin in control of food intake andappetite has made it an attractive target for obesity research. Indeed,few other natural substances have been demonstrated to be involved inthe modulation of both GH secretion and food intake.

An additional effect of ghrelin that has not to date been exploited fortherapeutic purposes is in modulating gastric motility and gastric acidsecretion. The pro-kinetic activity appears to be independent of theGH-secretory action and is likely mediated by the vagal-cholinergicmuscarinic pathway. The dose levels required are equivalent to thosenecessary for the hormone's GH and appetite stimulation actions. It isnoteworthy that, in contrast to its inactivity for ghrelin's otheractions, the des-Gln¹⁴ peptide demonstrated promotion of motility aswell. (Trudel, L.; Bouin, M.; Tomasetto, C.; Eberling, P.; St-Pierre,S.; Bannon, P.; L'Heureux, M. C.; Poitras, P. Two new peptides toimprove post-operative gastric ileus in dog. Peptides 2003, 24, 531-534;Trudel, L.; Tomasetto, C.; Rio, M. C.; Bouin, M.; Plourde, V.; Eberling,P.; Poitras, P. Ghrelin/motilin-related peptide is a potent prokineticto reverse gastric postoperative ileus in rats. Am. J. Physiol. 2002,282, G948-G952; Peeters, T. L. Central and peripheral mechanisms bywhich ghrelin regulates gut motility. J. Physiol. Pharmacol. 2003,54(Supp. 4), 95-103.)

Ghrelin also has been implicated in various aspects of reproduction andneonatal development. (Arvat, E.; Gianotti, L.; Giordano, R.; et al.Growth hormone-releasing hormone and growth hormonesecretagogue-receptor ligands. Focus on reproductive system. Endocrine2001, 14, 35-43) Also of significance are the cardiovascular effects ofghrelin, since the peptide is a powerful vasodilator. As such, ghrelinagonists have potential for the treatment of chronic heart failure(Nagaya, N.; Kangawa, K. Ghrelin, a novel growth hormone-releasingpeptide, in the treatment of chronic heart failure. Regul. Pept. 2003,114, 71-77; Nagaya, N.; Kangawa, K. Ghrelin improves left ventriculardysfunction and cardiac cachexia in heart failure. Curr. Opin. Pharmacol2003, 3, 146-151; Bedendi, I.; Alloatti, G.; Marcantoni, A.; Malan, D.;Catapano, F.; Ghe, C.; et al. Cardiac effects of ghrelin and itsendogenous derivatives des-octanoyl ghrelin and des-Gln¹⁴-ghrelin. Eur.J. Pharmacol. 2003, 476, 87-95) Intl. Pat. Appl. Publ. WO 2004/014412describes the use of ghrelin agonists for the protection of cell deathin myocardial cells and as a cardioprotectant treatment for conditionsleading to heart failure. Lastly, evidence has been obtained thatghrelin may have implications in anxiety and other CNS disorders as wellas the improvement of memory. (Carlini, V. P., Monzon, M. E., Varas, M.M., Cragnolini, A. B., Schioth, H. B., Scimonelli, T. N., de Barioglio,S. R. Ghrelin increases anxiety-like behavior and memory retention inrats. Biochem. Biophys. Res. Commun. 2002, 299, 739-743)

The myriad effects of ghrelin in humans have suggested the existence ofsubtypes for its receptor, although none have as yet been identified.(Torsello, A.; Locatelli, Y.; Melis, M. R.; Succu, S.; Spano, M. S.;Deghenghi, R.; Muller, E. E.; Argiolas, A.; Torsello, A.; Locatelli, V.;et al. Differential orexigenic effects of hexarelin and its analogs inthe rat hypothalamus: indication for multiple growth hormonesecretagogue receptor subtypes. Neuroendocrinology 2000, 72, 327-332.)However, a truncated, inactive form of GHS-R1a, termed GHS-R1b, wasisolated and identified at the same time as the originalcharacterization. Evidence is mounting that additional receptor subtypescould be present in different tissues to explain the diverse effectsdisplayed by the endogenous peptides and synthetic GHS. For instance,high affinity binding sites for ghrelin and des-acyl ghrelin have alsobeen found in breast cancer cell lines, cardiomyocytes, and guinea pigheart that are involved in mediating the antiproliferative,cardioprotective and negative cardiac inotropic effects of the peptides.Similarly, specific GHS binding sites besides GHS-R1a and GHS-R1b havebeen found in prostate cancer cells. Further, ghrelin and des-acylghrelin exert different effects on cell proliferation in prostatecarcinoma cell lines. (Cassoni, P.; Ghé, C.; Marrocco, T.; et al.Expression of ghrelin and biological activity of specific receptors forghrelin and des-acyl ghrelin in human prostate neoplasms and relatedcell lines. Eur. J. Endocrinol. 2004, 150, 173-184) These variousreceptor subtypes may then be implicated independently in the wide arrayof biological activities displayed by the endogenous peptides andsynthetic GHS. Indeed, recently, the existence of receptor subtypes wasoffered as an explanation for the promotion of fat accumulation byghrelin, despite its potent stimulation of the lipolytic hormone, growthhormone. (Thompson, N. M.; Gill, D. A. S.; Davies, R.; Loveridge, N.;Houston, P. A.; Robinson, I. C. A. F.; Wells, T. Ghrelin anddes-octanoyl ghrelin promote adipogenesis directly in vivo by amechanism independent of the type 1a growth hormone secretagoguereceptor. Endocrinology 2004, 145, 234-242.) Further, this worksuggested that the ratio of ghrelin and des-acyl ghrelin productioncould help regulate the balance between adipogenesis and lipolysis inresponse to nutritional status.

The successful creation of peptidic ghrelin analogues that separate theGH-modulating effects of ghrelin from the effects on weight gain andappetite provides strong evidence for the existence and physiologicalrelevance of other receptor subtypes. (Halem, H. A.; Taylor, J. E.;Dong, J. Z.; Shen, Y.; Datta, R.; Abizaid, A.; Diano, S.; Horvath, T.;Zizzari, P.; Bluet-Pajot, M.-T.; Epelbaum, J.; Culler, M. D. Novelanalogs of ghrelin: physiological and clinical implications. Eur. J.Endocrinol. 2004, 151, S71-S75.) BIM-28163 functions as an antagonist atthe GHS-R1a receptor and inhibits receptor activation by native ghrelin.However, this same molecule is a full agonist with respect tostimulating weight gain and food intake. Additionally, the existence ofa still uncharacterized receptor subtype has been proposed based onbinding studies in various tissues that showed differences betweenpeptidic and non-peptidic GHS. (Ong, H.; Menicoll, N.; Escher, F.;Collu, R.; Deghenghi, R.; Locatelli, V.; Ghigo, E.; Muccioli, G.;Boghen, M.; Nilsson, M. Endocrinology 1998, 139, 432-435.) Differencesbetween overall GHS-R expression and that of the GHS-R1a subtype in rattestis have been reported. (Barreiro, M. L.; Suominen, J. S.; Gaytan,F.; Pinilla, L.; Chopin, L. K.; Casanueva, F. F.; Dieguez, C.; Aguilar,E.; Toppari, J.; Tena-Sempere, M. Developmental, stage-specific, andhormonally regulated expression of growth hormone secretagogue receptormessenger RNA in rat testis. Biol. Reproduction 2003, 68, 1631-1640) AGHS-R subtype on cholinergic nerves is postulated as an explanation forthe differential actions of ghrelin and a peptidic GHS on neuralcontractile response observed during binding studies at the motilinreceptor. (Depoortere, I.; Thijs, T.; Thielemans, L.; Robberecht, P.;Peeters, T. L. Interaction of the growth hormone-releasing peptidesghrelin and growth hormone-releasing peptide-6 with the motilin receptorin the rabbit gastric antrum. J. Pharmacol. Exp. Ther. 2003, 305,660-667.)

The variety of activities associated with the ghrelin receptor couldalso be due to different agonists activating different signalingpathways as has been shown for ghrelin and adenosine, both of whichinteract as agonists at GHS-R1a (Carreira, M. C.; Camina, J. P.; Smith,R. G.; Casanueva, F. F. Agonist-specific coupling of growth hormonesecretagogue receptor type 1a to different intracellular signalingsystems. Role of adenosine. Neuroendocrinology 2004, 79, 13-25.)

The functional activity of a GPCR has been shown to often require theformation of dimers or other multimeric complexes with itself or otherproteins. (Park, P. S.; Filipek, S.; Wells, J. W.; Palczewski, K.Oligomerization of G protein-coupled receptors: past, present, andfuture. Biochemistry 2004, 43, 15643-15656; Rio, C. D.; Jordan, B. A.;Gomes, I.; Devi, L. A. G-protein-coupled receptor dimerization:modulation of receptor function. Pharmacol. Ther. 2001, 92, 71-87; Devi,L. A. Heterodimerization of G-protein-coupled receptors: pharmacology,signaling and trafficking. Trends Pharmacol. Sci. 2001, 22, 532-537.)Likewise, the activity of the ghrelin receptor might also be at leastpartially governed by such complexes. For example, certain reportsindicate that interaction of GHS-R1a with GHRH (Cunha, S. R.; Mayo, K.E. Ghrelin and growth hormone (GH) secreatagogues potentiateGH-releasing hormone (GHRH)-induced cyclic adenosine 3′,5′-monophosphateproduction in cells expressing transfected GHRH and GH secretagoguereceptors. Endocrinology 2002, 143, 4570-4582; Malagón, M. M.; Luque, R.M.; Ruiz-Guerrero, E.; Rodríguez-Pacheco, F.; García-Navarro, S.;Casanueva, F. F.; Gracia-Navarro, F.; Castafño, J. P. Intracellularsignaling mechanisms mediating ghrelin-stimulated growth hormone releasein somatotropes Endocrinology 2003, 144, 5372-5380) or between receptorsubtypes (Chan, C. B.; Cheng, C. H. K. Identification and functionalcharacterization of two alternatively spliced growth hormonesecretagogue receptor transcripts from the pituitary of black seabreamAcanthopagrus schlegeli. Mol. Cell. Endocrinol. 2004, 214, 81-95) may beinvolved in modulating the function of the receptor.

The vast majority of reported approaches to exploiting the ghrelinreceptor for therapeutic purposes have focused on modulating metabolicfunctions. Similarly, the vast majority of literature on GHS focuses onconditions that can be treated via its GH promoting actions. Someembodiments of the invention described herein, in particular, takeadvantage of selective activation of the ghrelin receptor to provide anavenue for the treatment of diseases characterized by GI dysmotility.The improved GI motility observed with ghrelin demonstrates that ghrelinagonists may be useful in correcting conditions associated with reducedor restricted motility (Murray, C. D. R.; Kamm, M. A.; Bloom, S. R.;Emmanuel, A. V. Ghrelin for the gastroenterologist: history andpotential. Gastroenterology 2003, 125, 1492-1502; Fujino, K.; Inui, A.;Asakawa, A.; Kihara, N.; Fujimura, M.; Fujimiya, M. Ghrelin inducesfasting motor activity of the gastrointestinal tract in conscious fedrats. J. Physiol. 2003, 550, 227-240; Edholm, T.; Levin, F.; Hellstrom,P. M.; Schmidt, P. T. Ghrelin stimulates motility in the small intestineof rats through intrinsic cholinergic neurons. Regul. Pept. 2004, 121,25-30.)

Included among these conditions is post-operative ileus (POI, Luckey,A.; Livingston, E.; Taché, Y. Mechanisms and treatment of postoperativeileus. Arch. Surg. 2003, 138, 206-214; Baig, M. K.; Wexner, S. D.Postoperative ileus: a review. Dis. Colon Rectum 2004, 47, 516-526). POIis defined as the impairment of GI motility that routinely occursfollowing abdominal, intestinal, gynecological and pelvic surgeries. Inthe U.S. alone, 4.3 million surgeries annually induce POI, accountingfor an economic impact of over $1 billion. POI is considered adeleterious response to surgical manipulation with a variable durationthat generally persists for 72 hours. It is characterized by pain,abdominal distention or bloating, nausea and vomiting, accumulation ofgas and fluids in the bowel, and delayed passage of stool. Patients areneither able to tolerate oral feeding nor to have bowel movements untilgut function returns. POI leads to numerous undesirable consequences,including increased patient morbidity, the costly prolongation ofhospital stays and, further, is a major cause of hospital readmission.In addition, opiate drugs given as analgesics after surgery exacerbatethis condition due to their well-recognized side effect of inhibitingbowel function.

Surgical manipulation of the stomach or intestine causes adisorganization of the gut-brain signaling pathways, impairing GIactivity and triggering POI. Ghrelin acts locally in the stomach tostimulate and coordinate the firing of vagal afferent neurons andthereby modulate gut motility. Thus, ghrelin accelerates gastricemptying in humans and is a potent agent proven to treat POI in animalmodels. Ghrelin agonists duplicate the effects of ghrelin, thustargeting directly the underlying cause of POI to acceleratenormalization of gut function and enable more rapid discharge from thehospital. Intravenous administration is often the preferred route oftreatment for POI due to the impaired GI motility in these patients thatimpedes oral therapy. No agent is currently approved by the U.S. FDAspecifically for the treatment of POI.

Another major motility disorder is gastroparesis, a particular problemfor both type I and type II diabetics. (Camilleri, M. Advances indiabetic gastroparesis. Rev. Gastroenterol. Disord. 2002, 2, 47-56; Tacket al. Gastroenterology 2004; 126: A485; Moreaux, B.; VandenBerg, J.;Thielmans, L.; Meulemans, A.; Coulie, B. Activation of the GHS receptoraccelerates gastric emptying in the dog. Digestive Disease Week, 15-20May 2004, New Orleans, La., USA Abstract M1009; Tack et al.Gastroenterology 2004, 126: A74) Gastroparesis (“stomach paralysis”) isa syndrome characterized by delayed gastric emptying in the absence ofany mechanical obstruction. It is variably characterized by abdominalpain, nausea, vomiting, weight loss, anorexia, early satiety,malnutrition, dehydration, gastroesophageal reflux, cramping andbloating. This chronic condition can lead to frequent hospitalization,increased disability and decreased quality of life. Severe, symptomaticgastroparesis is common in individuals suffering from diabetes,affecting from 5-10% of diabetics for a total patient population of 1million in the U.S. alone. Neuropathy is a frequent, debilitatingcomplication of diabetes. Visceral neuropathy results in GI dysfunction,especially involving the stomach, and leading to impaired gastricmotility. Ghrelin promotes gastric emptying both by stimulating thevagus nerve and via direct prokinetic action at the gastric mucosa.Moreover, a recent clinical study indicates that intravenousadministration of the natural ghrelin peptide is an effective acutetherapy in diabetic gastroparesis patients. A ghrelin agonist wouldtherefore be highly effective in overcoming the fundamental motilitybarrier faced by gastroparesis patients and correcting this condition.As with POI, no accepted or efficacious therapy for diabeticgastroparesis is available and most current therapies aim to provideonly symptomatic relief. Further, many of the therapeutics indevelopment have a mechanism of action similar to earlier products thathave failed in this indication. Surgical procedures may ameliorate thedisease process, but offer no possibility of cure.

Opioid-induced bowel dysfunction (OBD, Kurz, A.; Sessler, D. J.Opioid-Induced Bowel Dysfunction. Drugs 2003, 63, 649-671.) is the termapplied to the confluence of symptoms involving the reduced GI motilitythat results from treatment with opioid analgesics. Approximately 40-50%of patients taking opioids for pain control experience OBD. It ischaracterized by hard, dry stools, straining, incomplete evacuation,bloating, abdominal distension and increased gastric reflux. In additionto the obvious short-term distress, this condition leads to physical andpsychological deterioration in patients undergoing long term opioidtreatment. Further, the dysfunction can be so severe as to become adose-limiting adverse effect that actually prevents adequate paincontrol. As with POI, a ghrelin agonist can be expected to counteractthe dysmotility resulting from opioid use.

Two less common syndromes may also be helped through the GI motilitystimulation effects of ghrelin and ghrelin agonists. Short bowelsyndrome is a condition that occurs after resection of a substantialportion of small intestine and is characterized by malnutrition.Patients are observed to have decreased ghrelin levels resulting fromloss of the ghrelin-producing neuroendocrine cells of the intestine. Itis possible the short bowel feeds back on the release of the hormone.(Krsek, M.; Rosicka, M.; Haluzik, M.; et al. Plasma ghrelin levels inpatients with short bowel syndrome. Endocr. Res. 2002, 28, 27-33.)Chronic intestinal pseudo-obstruction is a syndrome defined by thepresence of chronic intestinal dilation and dysmotility in the absenceof mechanical obstruction or inflammation. Both genetic and acquiredcauses are known to result in this disorder, which affects high numbersof individuals worldwide annually. (Hirano, I.; Pandolfino, J. Chronicintestinal pseudo-obstruction. Dig. Dis. 2000, 18, 83-92.)

Other conditions and disorders that could be addressed throughstimulation of the ghrelin receptor are: emesis such as caused by cancerchemotherapy, constipation such as associated with the hypomotilityphase of irritable bowel syndrome (IBS), delayed gastric emptyingassociated with wasting conditions, gastroesophageal reflux disease(GERD), gastric ulcers (Sibilia, V.; Rindi, G.; Pagani, F.; Rapetti, D.;Locatelli, V.; Torsello, A.; Campanini, N.; Degenghi, R.; Netti, C.Ghrelin protects against ethanol-induced gastric ulcers in rats: studieson the mechanism of action. Endocrinology 2003, 144, 353-359.) andCrohn's disease.

Additionally, GI dysmotility is a significant problem in other mammalsas well. For example, the motility dysfunction termed ileus or colic isthe number one cause of mortality among horses. Further, ileus is one ofthe most common complications of equine intestinal surgery, in otherwords, post-operative ileus. This condition may also have a non-surgicaletiology. Some horses may be predisposed to ileus based upon the anatomyand functioning of their digestive tract. Virtually any horse issusceptible to colic with only minor differences based upon age, sex andbreed. Additionally, ileus may affect other animals, for examplecanines. (Roussel, A. J., Jr.; Cohen, N. D.; Hooper, R. N.; Rakestraw,P. C. Risk factors associated with development of postoperative ileus inhorses. J. Am. Vet. Med. Assoc. 2001, 219, 72-78; Van Hoogmoed, L. M.;Nieto, J. E.; Snyder, J. R.; Harmon, F. A. Survey of prokinetic use inhorses with gastrointestinal injury. Vet. Surg. 2004, 33, 279-285.)

Importantly, for most of the above conditions, no specific, approvedtherapeutics exist and most therapies simply address symptomatic relief.However, specific modulation of the ghrelin receptor will provide anopportunity to directly target the site of pathophysiologicaldisturbance to better treat the underlying condition and improveclinical outcome. Further, unlike other agents that interact at theGHS-R1a receptor, the compounds of the invention are believed not tostimulate concurrent GH secretion. This separation of thegastrointestinal and GH effects has not previously been reported for anymodulators of this receptor. However, as already mentioned, theexistence of analogues that separate the appetite control and GHmodulatory effects associated with ghrelin has been recently reported(Eur. J. Endocrinol. 2004, 151, S71-S75.)

WO 01/00830 reports on short gastrointestinal peptides (SGIP) thatsecrete growth hormone and also promote GI motility, but these were notshown to be due to action at the ghrelin receptor. U.S. Pat. No.6,548,501 discloses specific compounds, but as GHS, useful forstimulation of GI motility. Moreover, other endogenous factors are knownto stimulate secretion of GH, but do not promote GI motility. Indeed,many actually inhibit this physiological function. Specific receptoragonists such as the compounds of the present invention have much betterpotential to be selective and effective therapeutic agents.

Work has continued at the development of potent and selective GHS with anumber of small molecule derivatives now being known as has beenrecently summarized. (Carpino, P. Exp. Opin. Ther. Patents 2002, 12,1599-1618.) Specific GHS are described in the following U.S. Pat. Nos.and Intl. Pat. Appl. Publs. WO 89/07110; WO 89/07111; WO 92/07578; WO93/04081; WO 94/11012; WO 94/13696; WO 94/19367; WO 95/11029; WO95/13069; WO 95/14666; WO 95/17422; WO 95/17423; WO 95/34311; WO96/02530; WO 96/15148; WO 96/22996; WO 96/22997; WO 96/24580; WO96/24587; WO 96/32943; WO 96/33189; WO 96/35713; WO 96/38471; WO97/00894; WO 97/06803; WO 97/07117; WO 97/09060; WO 97/11697; WO97/15191; WO 97/15573; WO 97/21730; WO 97/22004; WO 97/22367; WO97/22620; WO 97/23508; WO 97/24369; WO 97/34604; WO 97/36873; WO97/38709; WO 97/40023; WO 97/40071; WO 97/41878; WO 97/41879; WO97/43278; WO 97/44042; WO 97/46252; WO 98/03473; WO 98/10653; WO98/18815; WO 98/22124; WO 98/46569; WO 98/51687; WO 98/58947; WO98/58948; WO 98/58949; WO 98/58950; WO 99/08697; WO 99/09991; WO99/36431; WO 99/39730; WO 99/45029; WO 99/58501; WO 99/64456; WO99/65486, WO 99/65488; WO 00/01726; WO 00/10975; WO 01/47558; WO01/92292; WO 01/96300; WO 01/97831; U.S. Pat. No. 3,239,345; U.S. Pat.No. 4,036,979; U.S. Pat. No. 4,411,890; U.S. Pat. No. 5,492,916; U.S.Pat. No. 5,494,919; U.S. Pat. No. 5,559,128; U.S. Pat. No. 5,663,171;U.S. Pat. No. 5,721,250; U.S. Pat. No. 5,721,251; U.S. Pat. No.5,723,616; U.S. Pat. No. 5,726,319; U.S. Pat. No. 5,767,124; U.S. Pat.No. 5,798,337; U.S. Pat. No. 5,830,433; U.S. Pat. No. 5,919,777; U.S.Pat. No. 6,034,216; U.S. Pat. No. 6,548,501; U.S. Pat. No. 6,559,150;U.S. Pat. No. 6,576,686; U.S. Pat. No. 6,686,359; and U.S. Pat. Appl.Nos. 2002/0168343; 2003/100494; 2003/130284; 2003/186844.

Despite this immense body of work, cyclic compounds have rarely beenfound to act at the receptor. When they have, antagonist activity hasbeen more prevalent. For example, the 14-amino acid compound,vapreotide, an SRIH-14 agonist and somatostatin mimetic, wasdemonstrated to be a ghrelin antagonist. (Deghenghi R, Papotti M, GhigoE, et al. Somatostatin octapeptides (lanreotide, octreotide, vapreotide,and their analogs) share the growth hormone-releasing peptide receptorin the human pituitary gland. Endocrine 2001, 14, 29-33.) The bindingand antagonist activities of analogues of cortistatin, a cyclicneuropeptide known to bind nonselectively to somatostatin receptors, tothe growth hormone secretagogue receptor have been reported (Intl. Pat.Appl. WO 03/004518). (Deghenghi R, Broglio F, Papotti M, et al.Targeting the ghrelin receptor—Orally active GHS and cortistatinanalogs. Endocrine 2003, 22, 13-18) In particular, one of theseanalogues, EP01492 (cortistatin-8) has been advanced into preclinicalstudies for the treatment of obesity as a ghrelin antagonist. Thesecompounds exhibit an IC₅₀ of 24-33 nM. In addition, these cycliccompounds and their derivatives, plus their use with metal bindingagents have been described for their ability to be useful forradiodiagnostic or radiotherapeutic use in the treatment of tumors andacromegaly.

Cyclic and linear analogues of growth hormone 177-191 have been studiedas treatments for obesity (WO 99/12969), with one particular compound,AOD9604, having entered the clinic for this indication. A compoundalready studied that is most similar to the molecules of the presentinvention is the GHS, G-7203 (EC₅₀=0.43 nM), the cyclic peptide analogueof the growth hormone releasing peptide, GHRP-2 (Elias, K. A.; Ingle, G.S.; Burnier, J. P.; Hammonds, G.; McDowell, R. S.; Rawson, T. E.;Somers, T. C.; Stanley, M. S.; Cronin, M. J. In vitro characterizationof four novel classes of growth hormone-releasing peptide. Endocrinol.1995, 136, 5694-5699) However, simplification of this cyclic derivativeled to still potent, linear compounds, whereas, for compounds of theinvention, linear analogues have been found to be devoid of ghrelinreceptor activity.

The macrocyclic compounds of the invention possess agonist activity. Aspreviously mentioned, however, unlike other agonists of the hGHS-R1areceptor, the compounds of the invention unexpectedly have aninsignificant stimulatory effect on the release of growth hormone.Accordingly, the compounds of the present invention can exhibitselective action in the GI tract or for metabolic disorders without sideeffects due to GH release.

SUMMARY OF THE INVENTION

The present invention provides novel conformationally-definedmacrocyclic compounds. These compounds can function as modulators, inparticular agonists, of the ghrelin (growth hormone secretagogue)receptor (GHS-R1a).

According to aspects of the present invention, the present inventionrelates to compounds according to formula I, II and/or III:

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof,wherein:

R₁ is hydrogen or the side chain of an amino acid, or alternatively R₁and R₂ together form a 4-, 5-, 6- or 7-membered ring, optionallycomprising an O, S or N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below, or alternatively R₁ and R₉together form a 3-, 4-, 5-, 6- or 7-membered ring, optionally comprisingan O, S or additional N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below;

R₂ is hydrogen or the side chain of an amino acid, or alternatively, R₁and R₂ together form a 4-, 5-, 6- or 7-membered ring, optionallycomprising an O, S or N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below; or alternatively R₂ and R₉together form a 3-, 4-, 5-, 6- or 7-membered ring, optionally comprisingan O, S or additional N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below;

R₃ is hydrogen or the side chain of an amino acid, or alternatively R₃and R₄ together form a 3-, 4-, 5-, 6- or 7-membered ring, optionallycomprising an O or S atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below, or alternatively, R₃ and R₇ or R₃and R₁₁ together form a 4-, 5-, 6-, 7- or 8-membered heterocyclic ring,optionally comprising an O, S or additional N atom in the ring, whereinthe ring is optionally substituted with R₈ as defined below;

R₄ is hydrogen or the side chain of an amino acid, or alternatively R₄and R₃ together form a 3-, 4-, 5-, 6- or 7-membered ring, optionallycomprising an O or S atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below, or alternatively R₄ and R₇ or R₄and R₁₁ together form a 4-, 5-, 6-, 7- or 8-membered heterocyclic ring,optionally comprising an O, S or additional N atom in the ring, whereinthe ring is optionally substituted with R₈ as defined below;

R₅ and R₆ are each independently hydrogen or the side chain of an aminoacid or alternatively R₅ and R₆ together form a 3-, 4-, 5-, 6- or7-membered ring, optionally comprising an O, S or N atom in the ring,wherein the ring is optionally substituted with R₈ as defined below;

R₇ is hydrogen, lower alkyl, substituted lower alkyl, cycloalkyl,substituted cycloalkyl, a heterocyclic group, or a substitutedheterocyclic group, or alternatively R₃ and R₇ or R₄ and R₇ togetherform a 3-, 4-, 5-, 6-, 7- or 8-membered heterocyclic ring optionallycomprising an O, S or additional N atom in the ring, wherein the ring isoptionally substituted with R₈ as described below;

R₈ is substituted for one or more hydrogen atoms on the 3-, 4-, 5-, 6-,7- or 8-membered ring structure and is independently selected from thegroup consisting of alkyl, substituted alkyl, cycloalkyl, substitutedcycloalkyl, a heterocyclic group, a substituted heterocyclic group,aryl, substituted aryl, heteroaryl, substituted heteroaryl, hydroxy,alkoxy, aryloxy, oxo, amino, halogen, formyl, acyl, carboxy,carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino, ureido, amidino,mercapto, sulfinyl, sulfonyl and sulfonamido, or, alternatively, R₈ is afused cycloalkyl, a substituted fused cycloalkyl, a fused heterocyclic,a substituted fused heterocyclic, a fused aryl, a substituted fusedaryl, a fused heteroaryl or a substituted fused heteroaryl ring whensubstituted for hydrogen atoms on two adjacent atoms;

X is O, NR₉ or N(R₁₀)₂ ⁺;

-   -   wherein R₉ is hydrogen, lower alkyl, substituted lower alkyl,        sulfonyl, sulfonamido or amidino and R₁₀ is hydrogen, lower        alkyl, or substituted lower alkyl, or alternatively R₉ and R₁        together form a 3-, 4-, 5-, 6- or 7-membered ring, optionally        comprising an O, S or additional N atom in the ring, wherein the        ring is optionally substituted with R₈ as defined above;

Z₁ is O or NR₁₁,

-   -   wherein R₁₁ is hydrogen, lower alkyl, or substituted lower        alkyl, or alternatively R₃ and R₁₁ together or R₄ and R₁₁        together form a 4-, 5-, 6-, 7- or 8-membered heterocyclic ring,        optionally comprising an O, S or additional N atom in the ring,        wherein the ring is optionally substituted with R₈ as defined        above;

Z₂ is O or NR₁₂, wherein R₁₂ is hydrogen, lower alkyl, or substitutedlower alkyl;

m, n and p are each independently 0, 1 or 2;

T is a bivalent radical of formula IV:—U—(CH₂)_(d)—W—Y—Z—(CH₂)_(e)—  (IV)

-   -   wherein d and e are each independently 0, 1, 2, 3, 4 or 5; Y and        Z are each optionally present; U is —CR₂₁R₂₂— or —C(═O)— and is        bonded to X of formula I; W, Y and Z are each independently        selected from the group consisting of —O—, —NR₂₃—, —S—, —Se,        —SO₂—, —C(═O)—O—, —O—C(═O)—, —C(═O)—NH—, —NH—C(═O)—, —SO₂—NH—,        —NH—SO₂—, —CR₂₄R₂₅—, —CH═CH— with the configuration Z or E, —C≡C        and the ring structures below:

-   -   -   wherein G₁ and G₂ are each independently a covalent bond or            a bivalent radical selected from the group consisting of            —O—, —NR₃₉—, —S—, —SO—, —SO₂—, —C(═O)—, —C(═O)—, —(C(═O),            —C(═O)NH—, —NH—C(═O)—, —SO₂—NH—, —NH—SO₂—, —CR₄₀R₄₁—,            —CH═CH— with the configuration Z or E, and —C≡C; with GI            being bonded closest to the group U, wherein any carbon atom            in the rings not otherwise defined, can be replaced by N,            with the proviso that the ring cannot contain more than four            N atoms; K₁, K₂, K₃, K₄ and K₅ are each independently O,            NR₄₂ or S, wherein R₄₂ is as defined below;        -   R₂₁ and R₂₂ are each independently hydrogen, lower alkyl, or            substituted lower alkyl, or alternatively R₂₁ and R₂₂            together form a 3- to 12-membered cyclic ring optionally            comprising one or more heteroatoms selected from the group            consisting of O, S and N, wherein the ring is optionally            substituted with R₈ as defined above;        -   R₂₃, R₃₉ and R₄₂ are each independently hydrogen, alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl,            heterocyclic, substituted heterocyclic, aryl, substituted            aryl, heteroaryl, substituted heteroaryl, formyl, acyl,            carboxyalkyl, carboxyaryl, amido, amidino, sulfonyl or            sulfonamido;        -   R₂₄ and R₂₅ are each independently hydrogen, lower alkyl,            substituted lower alkyl, R_(AA), wherein R_(AA) is a side            chain of an amino acid such as a standard or unusual amino            acid, or alternatively R₂₄ and R₂₅ together form a 3- to            12-membered cyclic ring optionally comprising one or more            heteroatoms selected from the group consisting of O, S and            N; or alternatively one of R₂₄ or R₂₅ is hydroxy, alkoxy,            aryloxy, amino, mercapto, carbamoyl, amidino, ureido or            guanidino while the other is hydrogen, lower alkyl or            substituted lower alkyl, except when the carbon to which R₂₄            and R₂₅ are bonded is also bonded to another heteroatom;        -   R₂₆, R₃₁, R₃₅ and R₃₈ are each optionally present and, when            present, are substituted for one or more hydrogen atoms on            the indicated ring and each is independently selected from            the group consisting of halogen, trifluoromethyl, alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl, a            heterocyclic group, a substituted heterocyclic group, aryl,            substituted aryl, heteroaryl, substituted heteroaryl,            hydroxy, alkoxy, aryloxy, amino, formyl, acyl, carboxy,            carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino,            ureido, amidino, cyano, nitro, mercapto, sulfinyl, sulfonyl            and sulfonamido;        -   R₂₇ is optionally present and is substituted for one or more            hydrogen atoms on the indicated ring and each is            independently selected from the group consisting of alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl, a            heterocyclic group, a substituted heterocyclic group, aryl,            substituted aryl, heteroaryl, substituted heteroaryl,            hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl, carboxy,            carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino,            ureido, amidino, mercapto, sulfinyl, sulfonyl and            sulfonamido;        -   R₂₈, R₂₉, R₃₀, R₃₂, R₃₃, R₃₄, R₃₆ and R₃₇ are each            optionally present and, when no double bond is present to            the carbon atom to which it is bonded in the ring, two            groups are optionally present, and when present, is            substituted for one hydrogen present in the ring, or when no            double bond is present to the carbon atom to which it is            bonded in the ring, is substituted for one or both of the            two hydrogen atoms present on the ring and each is            independently selected from the group consisting of alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl, a            heterocyclic group, a substituted heterocyclic group, aryl,            substituted aryl, heteroaryl, substituted heteroaryl,            hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl, carboxy,            carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino,            ureido, amidino, mercapto, sulfinyl, sulfonyl, sulfonamido            and, only if a double bond is present to the carbon atom to            which it is bonded, halogen; and        -   R₄₀ and R₄₁ are each independently hydrogen, lower alkyl,            substituted lower alkyl, R_(AA) as defined above, or            alternatively R₄₀ and R₄₁ together form a 3- to 12-membered            cyclic ring optionally comprising one or more heteroatoms            selected from the group consisting of O, S and N wherein the            ring is optionally substituted with R₈ as defined above, or            alternatively one of R₄₀ and R₄₁ is hydroxy, alkoxy,            aryloxy, amino, mercapto, carbamoyl, amidino, ureido or            guanidino, while the other is hydrogen, lower alkyl or            substituted lower alkyl, except when the carbon to which R₄₀            and R₄₁ are bonded is also bonded to another heteroatom;

    -   with the proviso that T is not an amino acid residue, dipeptide        fragment, tripeptide fragment or higher order peptide fragment        including standard amino acids;

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof,wherein:

R₅₀ is —(CH₂)_(ss)CH₃, —CH(CH₃)(CH₂)_(tt)CH₃, —(CH₂)_(uu)CH(CH₃)₂,—C(CH₃)₃, —(CHR₅₅)_(vv)—R₅₆, or —CH(OR₅₇)CH₃, wherein ss is 1, 2 or 3;tt is 1 or 2; uu is 0, 1 or 2; and vv is 0, 1, 2, 3 or 4; R₅₅ ishydrogen or C₁-C₄ alkyl; R₅₆ is amino, hydroxy, alkoxy, cycloalkyl orsubstituted cycloalkyl; and R₅₇ is hydrogen, alkyl, acyl, amino acyl,sulfonyl, carboxyalkyl or carboxyaryl;

R₅₁ is hydrogen, C₁-C₄ alkyl or C₁-C₄ alkyl substituted with hydroxy oralkoxy;

R₅₂ is —(CHR₅₈)_(ww)R₅₉, wherein ww is 0, 1, 2 or 3; R₅₈ is hydrogen,C₁-C₄ alkyl, amino, hydroxy or alkoxy; R₅₉ is aryl, substituted aryl,heteroaryl, substituted heteroaryl, cycloalkyl or substitutedcycloalkyl;

R₅₃ is hydrogen or C₁-C₄ alkyl;

X₂ is O, NR₉ or N(R₁₀)₂ ⁺;

-   -   wherein R₉ is hydrogen, lower alkyl, substituted lower alkyl,        sulfonyl, sulfonamido or amidino and R₁₀ is hydrogen, lower        alkyl, or substituted lower alkyl;

Z₅ is O or NR₁₂, wherein R₁₂ is hydrogen, lower alkyl, or substitutedlower alkyl; and

T₂ is a bivalent radical of formula V:—U_(a)—(CH₂)_(d)—W_(a)—Y_(a)—Z_(a)—(CH₂)_(e)—  (V)

-   -   wherein d and e are independently 0, 1, 2, 3, 4 or 5; Y_(a) and        Z_(a) are each optionally present; U_(a) is —CR₆₀R₆₁— or —C(═O)—        and is bonded to X₂ of formula II, wherein R₆₀ and R₆₁ are each        independently hydrogen, lower alkyl, or substituted lower alkyl,        or alternatively R₂₁ and R₂₂ together form a 3- to 12-membered        cyclic ring optionally comprising one or more heteroatoms        selected from the group consisting of O, S and N, wherein the        ring is optionally substituted with R₈ as defined above; W_(a),        Y_(a) and Z_(a) are each independently selected from the group        consisting of: —O—, —NR₆₂—, —S—, —SO—, —SO₂—, —C(═O)—O—,        —O—C(═O)—, —C(═O)—NH—, —NH—C(═O)—, —SO₂—NH—, —NH—SO₂—,        —CR₆₃R₆₄—, —CH═CH— with the configuration Z or E, —C≡C—, and the        ring structures depicted below:

-   -   -   wherein G₁ and G₂ are defined above, and wherein any carbon            atom in the ring is optionally replaced by N, with the            proviso that the aromatic ring cannot contain more than four            N atoms and the cycloalkyl ring cannot contain more than two            N atoms;            -   R₆₂ is hydrogen, alkyl, substituted alkyl, cycloalkyl,                substituted cycloalkyl, a heterocyclic group, a                substituted heterocyclic group, aryl, substituted aryl,                heteroaryl, substituted heteroaryl, formyl, acyl,                carboxyalkyl, carboxyaryl, amido, amidino, sulfonyl or                sulfonamido;            -   R₆₃ and R₆₄ are each independently hydrogen, lower                alkyl, substituted lower alkyl or R_(AA); or                alternatively R₆₃ and R₆₄ together form a 3- to                12-membered cyclic ring optionally comprising one or                more heteroatoms selected from the group consisting of                O, S and N; or alternatively one of R₆₃ and R₆₄ is                hydroxy, alkoxy, aryloxy, amino, mercapto, carbamoyl,                amidino, ureido or guanidino, while the other is                hydrogen, lower alkyl or substituted lower alkyl, except                when the carbon to which R₆₃ and R₆₄ are bonded is also                bonded to another heteroatom; and R_(AA) indicates the                side chain of an amino acid such as a standard or                unusual amino acid;            -   R₆₅ and R₆₈ are each optionally present, and, when                present are substituted for one or more hydrogen atoms                on the ring and each is independently halogen,                trifluoromethyl, alkyl, substituted alkyl, cycloalkyl,                substituted cycloalkyl, a heterocyclic group, a                substituted heterocyclic group, aryl, substituted aryl,                heteroaryl, substituted heteroaryl, hydroxy, alkoxy,                aryloxy, amino, formyl, acyl, carboxy, carboxyalkyl,                carboxyaryl, amido, carbamoyl, guanidino, ureido,                amidino, cyano, nitro, mercapto, sulfinyl, sulfonyl or                sulfonamido;            -   R₆₆ and R₆₇ are each optionally present, and when no                double bond is present to the carbon atom to which it is                bonded in the ring, two groups are optionally present,                and, when present, each is substituted for one hydrogen                present in the ring, or when no double bond is present                to the carbon atom to which it is bonded in the ring, is                substituted for one or both of the two hydrogen atoms                present on the ring and each is independently alkyl,                substituted alkyl, cycloalkyl, substituted cycloalkyl,                heterocyclic, substituted heterocyclic, aryl,                substituted aryl, heteroaryl, substituted heteroaryl,                hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl,                carboxy, carboxyalkyl, carboxyaryl, amido, carbamoyl,                guanidino, ureido, amidino, mercapto, sulfinyl,                sulfonyl, sulfonamide and, only if a double bond is                present to the carbon atom to which it is bonded,                halogen;            -   R₆₉ is optionally present, and when present is                substituted for one or more hydrogen atoms on the ring                and each is independently alkyl, substituted alkyl,                cycloalkyl, substituted cycloalkyl, a heterocyclic                group, a substituted heterocyclic group, aryl,                substituted aryl, heteroaryl, substituted heteroaryl,                hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl,                carboxy, carboxyalkyl, carboxyaryl, amido, carbamoyl,                guanidino, ureido, amidino, mercapto, sulfinyl, sulfonyl                or sulfonamido;            -   K₆ is O or S; and            -   ff is 1, 2, 3, 4 or 5;        -   with the proviso that T₂ is not an amino acid residue,            dipeptide fragment, tripeptide fragment or higher order            peptide fragment including standard amino acids;        -   or

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof, wherein:

R₇₀ is hydrogen, C₁-C₄ alkyl or alternatively R₇₀ and R₇₁ together forma 3-, 4-, 5-, 6- or 7-membered ring, optionally comprising an O, N or Satom in the ring, wherein the ring is optionally substituted with R_(8a)as defined below;

R₇₁ is hydrogen, —(CH₂)_(aa)CH₃, —CH(CH₃)(CH₂)_(bb)CH₃,—(CH₂)_(cc)CH(CH₃)₂, —(CH₂)_(dd)—R₇₆ or —CH(OR₇₇)CH₃ or, alternativelyR₇₁ and R₇₀ together form a 3-, 4-, 5-, 6- or 7-membered ring,optionally comprising an O, N or S atom in the ring, wherein the ring isoptionally substituted with R_(8a) as defined below; wherein aa is 0, 1,2, 3, 4 or 5; bb is 1, 2 or 3; cc is 0, 1, 2 or 3; and dd is 0, 1, 2, 3or 4; R₇₆ is aryl, substituted aryl, heteroaryl, substituted heteroaryl,cycloalkyl or substituted cycloalkyl; R₇₇ is hydrogen, alkyl, acyl,amino acyl, sulfonyl, carboxyalkyl or carboxyaryl;

R₇₂ is C₁-C₄ alkyl; or alternatively R₇₂ and R₇₃ together form a 3-, 4-,5-, 6- or 7-membered ring, optionally comprising an O or S atom in thering, wherein the ring is optionally substituted with R_(8b) as definedbelow;

R₇₃ is hydrogen, or alternatively R₇₃ and R₇₂ together form a 3-, 4-,5-, 6- or 7-membered ring, optionally comprising an O, S or N atom inthe ring, wherein the ring is optionally substituted with R_(8b) asdefined below;

R₇₄ is hydrogen or C₁-C₄ alkyl or alternatively R₇₄ and R₇₅ togetherform a 3-, 4-, 5-, 6- or 7-membered ring, optionally comprising an O, Nor S atom in the ring, wherein the ring is optionally substituted withR_(8s) as defined below;

R₇₅ is —(CHR₇₈)R₇₉ or alternatively R₇₅ and R₇₄ together form a 3-, 4-,5-, 6- or 7-membered ring, optionally comprising an O, N or S atom inthe ring, wherein the ring is optionally substituted with R₈, as definedbelow; wherein R₇₈ is hydrogen, C₁-C₄ alkyl, amino, hydroxy or alkoxy,and R₇₉ is selected from the group consisting of the followingstructures:

-   -   wherein E₁, E₂, E₃, E₄ and E₅ are each optionally present and        when present are each independently selected from the group        consisting of halogen, trifluoromethyl, alkyl, substituted        alkyl, cycloalkyl, substituted cycloalkyl, a heterocyclic group,        a substituted heterocyclic group, aryl, substituted aryl,        heteroaryl, substituted heteroaryl, hydroxy, alkoxy, aryloxy,        cyano, sulfinyl, sulfonyl and sulfonamido, and represent        substitution at one or more available positions on the        monocyclic or bicyclic aromatic ring, wherein said substitution        is made with the same or different selected group member, and J₁        and J₂ are each independently O or S;

R_(8a), R_(8b) and R_(8c) are each independently substituted for one ormore hydrogen atoms on the 3-, 4-, 5-, 6- or 7-membered ring structureand are independently selected from the group consisting of alkyl,substituted alkyl, cycloalkyl, substituted cycloalkyl, a heterocyclicgroup, a substituted heterocyclic group, aryl, substituted aryl,heteroaryl, substituted heteroaryl, hydroxy, alkoxy, aryloxy, oxo,amino, halogen, formyl, acyl, carboxy, carboxyalkyl, carboxyaryl, amido,carbamoyl, guanidino, ureido, amidino, mercapto, sulfinyl, sulfonyl andsulfonamido, or, alternatively, R_(8a), R_(8b) and R_(8c), are eachindependently a fused cycloalkyl, a substituted fused cycloalkyl, afused heterocyclic, a substituted fused heterocyclic, a fused aryl, asubstituted fused aryl, a fused heteroaryl or a substituted fusedheteroaryl ring when substituted for hydrogen atoms on two adjacentatoms;

X₃ is O, NR₉ or N(R₁₀)₂ ⁺;

-   -   wherein R₉ is hydrogen, lower alkyl, substituted lower alkyl,        sulfonyl, sulfonamido or amidino and R₁₀ is hydrogen, lower        alkyl, or substituted lower alkyl;

Z₁₀ is O or NR₁₂, wherein R₁₂ is hydrogen, lower alkyl, or substitutedlower alkyl; and

T₃ is the same as defined for T₂ with the exception that U_(a) is bondedto X₃ of formula III.

According to further aspects of the present invention, the compound is aghrelin receptor agonist or a GHS-R1a receptor agonist.

Further aspects of the present invention provide pharmaceuticalcompositions comprising: (a) a compound of the present invention; and(b) a pharmaceutically acceptable carrier, excipient or diluent.

Additional aspects of the present invention provide kits comprising oneor more containers containing pharmaceutical dosage units comprising aneffective amount of one or more compounds of the present inventionpackaged with optional instructions for the use thereof.

Aspects of the present invention further provide methods of stimulatinggastrointestinal motility, modulating GHS-R1a receptor activity in amammal and/or treating a gastrointestinal disorder comprisingadministering to a subject in need thereof an effective amount of amodulator that modulates a mammalian GHS-R1a receptor. In particularembodiments, interaction of the modulator and the GHS-R1a receptor doesnot result in a significant amount of growth hormone release. In stillother embodiments, the modulator is a compound of formula I, II and/orIII.

Additional aspects of the present invention provide methods ofdiagnosing tumors and/or acromegaly, comprising administering compoundsof the present invention and a radiolabeled metal binding agent anddetecting the binding of the composition to a biological target, andtreating tumors and/or acromegaly comprising administering atherapeutically effective amount of a composition comprising a compoundof the present invention.

Further aspects of the present invention relate to methods of making thecompounds of formula I, II and/or III.

Aspects of the present invention further relate to methods of preventingand/or treating disorders described herein, in particular,gastrointestinal disorders, including post-operative ileus,gastroparesis, such as diabetic and post-surgical gastroparesis,opioid-induced bowel dysfunction, chronic intestinal pseudo-obstruction,short bowel syndrome, emesis such as caused by cancer chemotherapy,constipation such as associated with the hypomotility phase of irritablebowel syndrome (IBS), delayed gastric emptying associated with wastingconditions, gastroesophageal reflux disease (GERD), gastric ulcers,Crohn's disease, gastrointestinal disorders characterized by dysmotilityand other diseases and disorders of the gastrointestinal tract.

The present invention also relates to compounds of formula I, II and/orIII used for the preparation of a medicament for prevention and/ortreatment of the disorders described herein.

The foregoing and other aspects of the present invention are explainedin greater detail in the specification set forth below.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a scheme presenting a general synthetic strategy to provideconformationally-defined macrocycles of the present invention.

FIG. 2 shows a general thioester strategy for making macrocycliccompounds of the present invention.

FIG. 3 shows a general ring-closing metathesis (RCM) strategy formacrocyclic compounds of the present invention.

FIG. 4 (panels A through E) shows competitive binding curves for bindingof exemplary compounds of the present invention to the hGHS-R1areceptor.

FIG. 5 (panels A through E) shows concentration-response curves foractivation of the hGHS-R1a receptor by exemplary compounds of thepresent invention.

FIG. 6 shows graphs depicting pharmacokinetic parameters for exemplarycompounds of the present invention, specifically after oraladministration of 8 mg/kg compound 298 (panel A), after subcutaneousinjection of 2 mg/kg compound 298 with cyclodextrin (panel B), afterintravenous administration of 2 mg/kg compound 25 with cyclodextrin(panel C) and after intravenous administration of 2 mg/kg compound 298with cyclodextrin (panel D).

FIG. 7 (panels A and B) shows graphs presenting effects on gastricemptying for exemplary compounds of the present invention.

FIG. 8 shows a graph presenting effects of postoperative ileus for anexemplary compound of the present invention.

FIG. 9 (panels A through D) shows graphs depicting the effect onpulsatile growth hormone release for an exemplary compound of thepresent invention.

FIG. 10 shows a competitive binding curve for binding of an exemplarycompound of the present invention to the hGHS-R1a receptor.

FIG. 11 shows an activation curve demonstrating the agonism of anexemplary compound of the present invention.

FIG. 12 shows a graph depicting agonism and lack of growth hormonerelease for an exemplary compound of the present invention.

FIG. 13 shows graphs depicting receptor desentization associated withbinding of an exemplary compound of the present invention to thehGHS-R1a receptor.

FIG. 14 (panels A and B) shows graphs presenting effects on gastricemptying for an exemplary compound of the present invention.

FIG. 15 shows a graph presenting effects on postoperative ileus for anexemplary compound of the present invention.

FIG. 16 shows graphs depicting reversal of morphine-delayed gastricemptying (panel A) and morphine-delayed gastrointestinal transit (panelB) for an exemplary compound of the present invention.

FIG. 17 (panels A and B) shows graphs depicting effects on gastroparesisfor exemplary compounds of the present invention.

DETAILED DESCRIPTION

The foregoing and other aspects of the present invention will now bedescribed in more detail with respect to other embodiments describedherein. It should be appreciated that the invention can be embodied indifferent forms and should not be construed as limited to theembodiments set forth herein. Rather, these embodiments are provided sothat this disclosure will be thorough and complete, and will fullyconvey the scope of the invention to those skilled in the art.

The terminology used in the description of the invention herein is forthe purpose of describing particular embodiments only and is notintended to be limiting of the invention. As used in the description ofthe invention and the appended claims, the singular forms “a”, “an” and“the” are intended to include the plural forms as well, unless thecontext clearly indicates otherwise. Additionally, as used herein, theterm “and/or” includes any and all combinations of one or more of theassociated listed items and may be abbreviated as “/”.

Unless otherwise defined, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs.

All publications, U.S. patent applications, U.S. patents and otherreferences cited herein are incorporated by reference in theirentireties.

The term “alkyl” refers to straight or branched chain saturated orpartially unsaturated hydrocarbon groups having from 1 to 20 carbonatoms, in some instances 1 to 8 carbon atoms. The term “lower alkyl”refers to alkyl groups containing 1 to 6 carbon atoms. Examples of alkylgroups include, but are not limited to, methyl, ethyl, isopropyl,tert-butyl, 3-hexenyl, and 2-butynyl. By “unsaturated” is meant thepresence of 1, 2 or 3 double or triple bonds, or a combination of thetwo. Such alkyl groups may also be optionally substituted as describedbelow.

When a subscript is used with reference to an alkyl or other hydrocarbongroup defined herein, the subscript refers to the number of carbon atomsthat the group may contain. For example, C₂-C₄ alkyl indicates an alkylgroup with 2, 3 or 4 carbon atoms.

The term “cycloalkyl” refers to saturated or partially unsaturatedcyclic hydrocarbon groups having from 3 to 15 carbon atoms in the ring,in some instances 3 to 7, and to alkyl groups containing said cyclichydrocarbon groups. Examples of cycloalkyl groups include, but are notlimited to, cyclopropyl, cyclopropylmethyl, cyclopentyl,2-(cyclohexyl)ethyl, cycloheptyl, and cyclohexenyl. Cycloalkyl asdefined herein also includes groups with multiple carbon rings, each ofwhich may be saturated or partially unsaturated, for example decalinyl,[2.2.1]-bicycloheptanyl or adamantanyl. All such cycloalkyl groups mayalso be optionally substituted as described below.

The term “aromatic” refers to an unsaturated cyclic hydrocarbon grouphaving a conjugated pi electron system that contains 4n+2 electronswhere n is an integer greater than or equal to 1. Aromatic molecules aretypically stable and are depicted as a planar ring of atoms withresonance structures that consist of alternating double and singlebonds, for example benzene or naphthalene.

The term “aryl” refers to an aromatic group in a single or fusedcarbocyclic ring system having from 6 to 15 ring atoms, in someinstances 6 to 10, and to alkyl groups containing said aromatic groups.Examples of aryl groups include, but are not limited to, phenyl,1-naphthyl, 2-naphthyl and benzyl. Aryl as defined herein also includesgroups with multiple aryl rings which may be fused, as in naphthyl andanthracenyl, or unfused, as in biphenyl and terphenyl. Aryl also refersto bicyclic or tricyclic carbon rings, where one of the rings isaromatic and the others of which may be saturated, partially unsaturatedor aromatic, for example, indanyl or tetrahydronaphthyl (tetralinyl).All such aryl groups may also be optionally substituted as describedbelow.

The term “heterocycle” or “heterocyclic” refers to saturated orpartially unsaturated monocyclic, bicyclic or tricyclic groups havingfrom 3 to 15 atoms, in some instances 3 to 7, with at least oneheteroatom in at least one of the rings, said heteroatom being selectedfrom O, S or N. Each ring of the heterocyclic group can contain one ortwo O atoms, one or two S atoms, one to four N atoms, provided that thetotal number of heteroatoms in each ring is four or less and each ringcontains at least one carbon atom. The fused rings completing thebicyclic or tricyclic heterocyclic groups may contain only carbon atomsand may be saturated or partially unsaturated. The N and S atoms mayoptionally be oxidized and the N atoms may optionally be quaternized.Heterocyclic also refers to alkyl groups containing said monocyclic,bicyclic or tricyclic heterocyclic groups. Examples of heterocyclicrings include, but are not limited to, 2- or 3-piperidinyl, 2- or3-piperazinyl, 2- or 3-morpholinyl. All such heterocyclic groups mayalso be optionally substituted as described below

The term “heteroaryl” refers to an aromatic group in a single or fusedring system having from 5 to 15 ring atoms, in some instances 5 to 10,which have at least one heteroatom in at least one of the rings, saidheteroatom being selected from O, S or N. Each ring of the heteroarylgroup can contain one or two O atoms, one or two S atoms, one to four Natoms, provided that the total number of heteroatoms in each ring isfour or less and each ring contains at least one carbon atom. The fusedrings completing the bicyclic or tricyclic groups may contain onlycarbon atoms and may be saturated, partially unsaturated or aromatic. Instructures where the lone pair of electrons of a nitrogen atom is notinvolved in completing the aromatic pi electron system, the N atoms mayoptionally be quaternized or oxidized to the N-oxide. Heteroaryl alsorefers to alkyl groups containing said cyclic groups. Examples ofmonocyclic heteroaryl groups include, but are not limited to pyrrolyl,pyrazolyl, pyrazolinyl, imidazolyl, oxazolyl, isoxazolyl, thiazolyl,thiadiazolyl, isothiazolyl, furanyl, thienyl, oxadiazolyl, pyridyl,pyrazinyl, pyrimidinyl, pyridazinyl, and triazinyl. Examples of bicyclicheteroaryl groups include, but are not limited to indolyl,benzothiazolyl, benzoxazolyl, benzothienyl, quinolinyl,tetrahydroisoquinolinyl, isoquinolinyl, benzimidazolyl, benzopyranyl,indolizinyl, benzofuranyl, isobenzofuranyl, chromonyl, coumarinyl,benzopyranyl, cinnolinyl, quinoxalinyl, indazolyl, purinyl,pyrrolopyridinyl, furopyridinyl, thienopyridinyl, dihydroisoindolyl, andtetrahydroquinolinyl. Examples of tricyclic heteroaryl groups include,but are not limited to carbazolyl, benzindolyl, phenanthrollinyl,acridinyl, phenanthridinyl, and xanthenyl. All such heteroaryl groupsmay also be optionally substituted as described below.

The term “hydroxy” refers to the group —OH.

The term “alkoxy” refers to the group —OR_(a), wherein R_(a) is alkyl,cycloalkyl or heterocyclic. Examples include, but are not limited tomethoxy, ethoxy, tert-butoxy, cyclohexyloxy and tetrahydropyranyloxy.

The term “aryloxy” refers to the group —OR_(b) wherein R_(b) is aryl orheteroaryl. Examples include, but are not limited to phenoxy, benzyloxyand 2-naphthyloxy.

The term “acyl” refers to the group —C(═O)—R_(c), wherein R_(c) isalkyl, cycloalkyl, heterocyclic, aryl or heteroaryl. Examples include,but are not limited to, acetyl, benzoyl and furoyl.

The term “amino acyl” indicates an acyl group that is derived from anamino acid.

The term “amino” refers to an —NR_(d)R_(e), group wherein R_(d) andR_(e) are independently selected from the group consisting of hydrogen,alkyl, cycloalkyl, heterocyclic, aryl and heteroaryl. Alternatively,R_(d) and R_(e) together form a heterocyclic ring of 3 to 8 members,optionally substituted with unsubstituted alkyl, unsubstitutedcycloalkyl, unsubstituted heterocyclic, unsubstituted aryl,unsubstituted heteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino, amido,carboxy, carboxyalkyl, carboxyaryl, mercapto, sulfinyl, sulfonyl,sulfonamido, amidino, carbamoyl, guanidino or ureido, and optionallycontaining one to three additional heteroatoms selected from O, S or N.

The term “amido” refers to the group —C(═O)—NR_(f)R_(g) wherein R_(f)and R_(g) are independently selected from the group consisting ofhydrogen, alkyl, cycloalkyl, heterocyclic, aryl and heteroaryl.Alternatively, R_(f) and R_(g) together form a heterocyclic ring of 3 to8 members, optionally substituted with unsubstituted alkyl,unsubstituted cycloalkyl, unsubstituted heterocyclic, unsubstitutedaryl, unsubstituted heteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino,amido, carboxy, carboxyalkyl, carboxyaryl, mercapto, sulfinyl, sulfonyl,sulfonamido, amidino, carbamoyl, guanidino or ureido, and optionallycontaining one to three additional heteroatoms selected from O, S or N.

The term “amidino” refers to the group —C(═NR_(h))NR_(i)R_(j) whereinR_(h) is selected from the group consisting of hydrogen, alkyl,cycloalkyl, heterocyclic, aryl and heteroaryl; and R_(i) and R_(j) areindependently selected from the group consisting of hydrogen, alkyl,cycloalkyl, heterocyclic, aryl and heteroaryl. Alternatively, R_(i) andR_(j) together form a heterocyclic ring of 3 to 8 members, optionallysubstituted with unsubstituted alkyl, unsubstituted cycloalkyl,unsubstituted heterocyclic, unsubstituted aryl, unsubstitutedheteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino, amido, carboxy,carboxyalkyl, carboxyaryl, mercapto, sulfinyl, sulfonyl, sulfonamido,amidino, carbamoyl, guanidino or ureido, and optionally containing oneto three additional heteroatoms selected from O, S or N.

The term “carboxy” refers to the group —CO₂H.

The term “carboxyalkyl” refers to the group —CO₂R_(k), wherein R_(k) isalkyl, cycloalkyl or heterocyclic.

The term “carboxyaryl” refers to the group —CO₂R_(m), wherein R_(m) isaryl or heteroaryl.

The term “cyano” refers to the group —CN.

The term “formyl” refers to the group —C(═O)H, also denoted —CHO.

The term “halo,” “halogen” or “halide” refers to fluoro, fluorine orfluoride, chloro, chlorine or chloride, bromo, bromine or bromide, andiodo, iodine or iodide, respectively.

The term “oxo” refers to the bivalent group ═O, which is substituted inplace of two hydrogen atoms on the same carbon to form a carbonyl group.

The term “mercapto” refers to the group —SR_(n) wherein R_(n) ishydrogen, alkyl, cycloalkyl, heterocyclic, aryl or heteroaryl.

The term “nitro” refers to the group —NO₂.

The term “trifluoromethyl” refers to the group —CF₃.

The term “sulfinyl” refers to the group —S(═O)R_(p) wherein R_(p) isalkyl, cycloalkyl, heterocyclic, aryl or heteroaryl.

The term “sulfonyl” refers to the group —S(═O)₂—R_(q1) wherein R_(q1) isalkyl, cycloalkyl, heterocyclic, aryl or heteroaryl.

The term “aminosulfonyl” refers to the group —NR_(q2)—S(═O)₂—R_(q3)wherein R_(q2) is hydrogen, alkyl, cycloalkyl, heterocyclic, aryl orheteroaryl; and 3 is alkyl, cycloalkyl, heterocyclic, aryl orheteroaryl.

The term “sulfonamido” refers to the group —S(═O)₂—NR_(r)R_(s) whereinR_(r) and R_(s) are independently selected from the group consisting ofhydrogen, alkyl, cycloalkyl, heterocyclic, aryl or heteroaryl.Alternatively, R_(r) and R_(s) together form a heterocyclic ring of 3 to8 members, optionally substituted with unsubstituted alkyl,unsubstituted cycloalkyl, unsubstituted heterocyclic, unsubstitutedaryl, unsubstituted heteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino,amido, carboxy, carboxyalkyl, carboxyaryl, mercapto, sulfinyl, sulfonyl,sulfonamido, amidino, carbamoyl, guanidino or ureido, and optionallycontaining one to three additional heteroatoms selected from O, S or N.

The term “carbamoyl” refers to a group of the formula—N(R_(t))—C(═O)—OR_(u) wherein R_(t) is selected from hydrogen, alkyl,cycloalkyl, heterocyclic, aryl or heteroaryl; and R_(u) is selected fromalkyl, cycloalkyl, heterocylic, aryl or heteroaryl.

The term “guanidino” refers to a group of the formula—N(R_(v))—C(═NR_(w))—NR_(x)R_(y) wherein R_(v), R_(w), R_(x) and R_(y)are independently selected from hydrogen, alkyl, cycloalkyl,heterocyclic, aryl or heteroaryl. Alternatively, R_(x) and R_(y)together form a heterocyclic ring or 3 to 8 members, optionallysubstituted with unsubstituted alkyl, unsubstituted cycloalkyl,unsubstituted heterocyclic, unsubstituted aryl, unsubstitutedheteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino, amido, carboxy,carboxyalkyl, carboxyaryl, mercapto, sulfinyl, sulfonyl, sulfonamido,amidino, carbamoyl, guanidino or ureido, and optionally containing oneto three additional heteroatoms selected from O, S or N.

The term “ureido” refers to a group of the formula—N(R_(z))—C(═O)—NR_(aa)R_(bb) wherein R_(z), R_(aa) and R_(bb) areindependently selected from hydrogen, alkyl, cycloalkyl, heterocyclic,aryl or heteroaryl. Alternatively, R_(aa) and R_(bb) together form aheterocyclic ring of 3 to 8 members, optionally substituted withunsubstituted alkyl, unsubstituted cycloalkyl, unsubstitutedheterocyclic, unsubstituted aryl, unsubstituted heteroaryl, hydroxy,alkoxy, aryloxy, acyl, amino, amido, carboxy, carboxyalkyl, carboxyaryl,mercapto, sulfinyl, sulfonyl, sulfonamido, amidino, carbamoyl, guanidinoor ureido, and optionally containing one to three additional heteroatomsselected from O, S or N.

The term “optionally substituted” is intended to expressly indicate thatthe specified group is unsubstituted or substituted by one or moresuitable substituents, unless the optional substituents are expresslyspecified, in which case the term indicates that the group isunsubstituted or substituted with the specified substituents. As definedabove, various groups may be unsubstituted or substituted (i.e., theyare optionally substituted) unless indicated otherwise herein (e.g., byindicating that the specified group is unsubstituted).

The term “substituted” when used with the terms alkyl, cycloalkyl,heterocyclic, aryl and heteroaryl refers to an alkyl, cycloalkyl,heterocyclic, aryl or heteroaryl group having one or more of thehydrogen atoms of the group replaced by substituents independentlyselected from unsubstituted alkyl, unsubstituted cycloalkyl,unsubstituted heterocyclic, unsubstituted aryl, unsubstitutedheteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino, amido, carboxy,carboxyalkyl, carboxyaryl, halo, oxo, mercapto, sulfinyl, sulfonyl,sulfonamido, amidino, carbamoyl, guanidino, ureido and groups of theformulas —NR_(cc)C(═O)R_(dd), —N_(ee)C(═NR_(ff))R_(gg),—OC(═O)NR_(hh)R_(ii), —OC(═O)R_(jj), —OC(═O)OR_(kk), —NR_(mm)SO₂R_(nn),or —NR_(pp)SO₂N_(qq)R_(rr) wherein R_(cc), R_(dd), R_(ee), R_(ff),R_(gg), R_(hh), R_(jj), R_(mm), R_(pp), R_(qq) and R_(rr), areindependently selected from hydrogen, unsubstituted alkyl, unsubstitutedcycloalkyl, unsubstituted heterocyclic, unsubstituted aryl orunsubstituted heteroaryl; and wherein R_(kk) and R_(nn) areindependently selected from unsubstituted alkyl, unsubstitutedcycloalkyl, unsubstituted heterocyclic, unsubstituted aryl orunsubstituted heteroaryl. Alternatively, R_(gg) and R_(hh), R_(jj) andR_(kk) or R_(pp) and R_(qq) together form a heterocyclic ring of 3 to 8members, optionally substituted with unsubstituted alkyl, unsubstitutedcycloalkyl, unsubstituted heterocyclic, unsubstituted aryl,unsubstituted heteroaryl, hydroxy, alkoxy, aryloxy, acyl, amino, amido,carboxy, carboxyalkyl, carboxyaryl, mercapto, sulfinyl, sulfonyl,sulfonamido, amidino, carbamoyl, guanidino or ureido, and optionallycontaining one to three additional heteroatoms selected from O, S or N.In addition, the term “substituted” for aryl and heteroaryl groupsincludes as an option having one of the hydrogen atoms of the groupreplaced by cyano, nitro or trifluoromethyl.

A substitution is made provided that any atom's normal valency is notexceeded and that the substitution results in a stable compound.Generally, when a substituted form of a group is present, suchsubstituted group is preferably not further substituted or, ifsubstituted, the substituent comprises only a limited number ofsubstituted groups, in some instances 1, 2, 3 or 4 such substituents.

When any variable occurs more than one time in any constituent or in anyformula herein, its definition on each occurrence is independent of itsdefinition at every other occurrence. Also, combinations of substituentsand/or variables are permissible only if such combinations result instable compounds.

A “stable compound” or “stable structure” refers to a compound that issufficiently robust to survive isolation to a useful degree of purityand formulation into an efficacious therapeutic agent.

The term “amino acid” refers to the common natural (genetically encoded)or synthetic amino acids and common derivatives thereof, known to thoseskilled in the art. When applied to amino acids, “standard” or“proteinogenic” refers to the genetically encoded 20 amino acids intheir natural configuration. Similarly, when applied to amino acids,“unnatural” or “unusual” refers to the wide selection of non-natural,rare or synthetic amino acids such as those described by Hunt, S. inChemistry and Biochemistry of the Amino Acids, Barrett, G. C., Ed.,Chapman and Hall: New York, 1985.

The term “residue” with reference to an amino acid or amino acidderivative refers to a group of the formula:

wherein R_(AA) is an amino acid side chain, and n=0, 1 or 2 in thisinstance.

The term “fragment” with respect to a dipeptide, tripeptide or higherorder peptide derivative indicates a group that contains two, three ormore, respectively, amino acid residues.

The term “amino acid side chain” refers to any side chain from astandard or unnatural amino acid, and is denoted R_(AA). For example,the side chain of alanine is methyl, the side chain of valine isisopropyl and the side chain of tryptophan is 3-indolylmethyl.

The term “agonist” refers to a compound that duplicates at least some ofthe effect of the endogenous ligand of a protein, receptor, enzyme orthe like.

The term “antagonist” refers to a compound that inhibits at least someof the effect of the endogenous ligand of a protein, receptor, enzyme orthe like.

The term “growth hormone secretagogue” (GHS) refers to any exogenouslyadministered compound or agent that directly or indirectly stimulates orincreases the endogenous release of growth hormone, growthhormone-releasing hormone, or somatostatin in an animal, in particular,a human. A GHS may be peptidic or non-peptidic in nature, in someinstances, with an agent that can be administered orally. In someinstances, the agent can induce a pulsatile response.

The term “modulator” refers to a compound that imparts an effect on abiological or chemical process or mechanism. For example, a modulatormay increase, facilitate, upregulate, activate, inhibit, decrease,block, prevent, delay, desensitize, deactivate, down regulate, or thelike, a biological or chemical process or mechanism. Accordingly, amodulator can be an “agonist” or an “antagonist.” Exemplary biologicalprocesses or mechanisms affected by a modulator include, but are notlimited to, receptor binding and hormone release or secretion. Exemplarychemical processes or mechanisms affected by a modulator include, butare not limited to, catalysis and hydrolysis.

The term “variant” when applied to a receptor is meant to includedimers, trimers, tetramers, pentamers and other biological complexescontaining multiple components. These components can be the same ordifferent.

The term “peptide” refers to a chemical compound comprised of two ormore amino acids covalently bonded together.

The term “peptidomimetic” refers to a chemical compound designed tomimic a peptide, but which contains structural differences through theaddition or replacement of one of more functional groups of the peptidein order to modulate its activity or other properties, such assolubility, metabolic stability, oral bioavailability, lipophilicity,permeability, etc. This can include replacement of the peptide bond,side chain modifications, truncations, additions of functional groups,etc. When the chemical structure is not derived from the peptide, butmimics its activity, it is often referred to as a “non-peptidepeptidomimetic.”

The term “peptide bond” refers to the amide [—C(═O)—NH—] functionalitywith which individual amino acids are typically covalently bonded toeach other in a peptide.

The term “protecting group” refers to any chemical compound that may beused to prevent a potentially reactive functional group, such as anamine, a hydroxyl or a carboxyl, on a molecule from undergoing achemical reaction while chemical change occurs elsewhere in themolecule. A number of such protecting groups are known to those skilledin the art and examples can be found in “Protective Groups in OrganicSynthesis,” Theodora W. Greene and Peter G. Wuts, editors, John Wiley &Sons, New York, 3^(rd) edition, 1999 [ISBN 0471160199]. Examples ofamino protecting groups include, but are not limited to, phthalimido,trichloroacetyl, benzyloxycarbonyl, tert-butoxycarbonyl, andadamantyloxycarbonyl. In some embodiments, amino protecting groups arecarbamate amino protecting groups, which are defined as an aminoprotecting group that when bound to an amino group forms a carbamate. Inother embodiments, amino carbamate protecting groups areallyloxycarbonyl (Alloc), benzyloxycarbonyl (Cbz),9-fluorenylmethoxycarbonyl (Fmoc), tert-butoxycarbonyl (Boc) andα,α-dimethyl-3,5-dimethoxybenzyloxycarbonyl (Ddz). For a recentdiscussion of newer nitrogen protecting groups: Theodoridis, G.Tetrahedron 2000, 56, 2339-2358. Examples of hydroxyl protecting groupsinclude, but are not limited to, acetyl, tert-butyldimethylsilyl(TBDMS), trityl (Trt), tert-butyl, and tetrahydropyranyl (THP). Examplesof carboxyl protecting groups include, but are not limited to methylester, tert-butyl ester, benzyl ester, trimethylsilylethyl ester, and2,2,2-trichloroethyl ester.

The term “solid phase chemistry” refers to the conduct of chemicalreactions where one component of the reaction is covalently bonded to apolymeric material (solid support as defined below). Reaction methodsfor performing chemistry on solid phase have become more widely knownand established outside the traditional fields of peptide andoligonucleotide chemistry.

The term “solid support,” “solid phase” or “resin” refers to amechanically and

chemically stable polymeric matrix utilized to conduct solid phasechemistry. This is denoted by “Resin,” “P-” or the following symbol:

Examples of appropriate polymer materials include, but are not limitedto, polystyrene, polyethylene, polyethylene glycol, polyethylene glycolgrafted or covalently bonded to polystyrene (also termedPEG-polystyrene, TentaGel™, Rapp, W.; Zhang, L.; Bayer, E. InInnovations and Persepetives in Solid Phase Synthesis. Peptides,Polypeptides and Oligonucleotides; Epton, R., Ed.; SPCC Ltd.:Birmingham, UK; p 205), polyacrylate (CLEAR™), polyacrylamide,polyurethane, PEGA [polyethyleneglycol poly(N,N-dimethylacrylamide)co-polymer, Meldal, M. Tetrahedron Lett. 1992, 33, 3077-3080],cellulose, etc. These materials can optionally contain additionalchemical agents to form cross-linked bonds to mechanically stabilize thestructure, for example polystyrene cross-linked with divinylbenezene(DVB, usually 0.1-5%, preferably 0.5-2%). This solid support can includeas non-limiting examples aminomethyl polystyrene, hydroxymethylpolystyrene, benzhydrylamine polystyrene (BHA), methylbenzhydrylamine(MBHA) polystyrene, and other polymeric backbones containing freechemical functional groups, most typically, —NH₂ or —OH, for furtherderivatization or reaction. The term is also meant to include“Ultraresins” with a high proportion (“loading”) of these functionalgroups such as those prepared from polyethyleneimines and cross-linkingmolecules (Barth, M.; Rademann, J. J Comb. Chem. 2004, 6, 340-349). Atthe conclusion of the synthesis, resins are typically discarded,although they have been shown to be able to be reused such as inFrechet, J. M. J.; Haque, K. E. Tetrahedron Lett. 1975, 16, 3055.

In general, the materials used as resins are insoluble polymers, butcertain polymers have differential solubility depending on solvent andcan also be employed for solid phase chemistry. For example,polyethylene glycol can be utilized in this manner since it is solublein many organic solvents in which chemical reactions can be conducted,but it is insoluble in others, such as diethyl ether. Hence, reactionscan be conducted homogeneously in solution, then the product on thepolymer precipitated through the addition of diethyl ether and processedas a solid. This has been termed “liquid-phase” chemistry.

The term “linker” when used in reference to solid phase chemistry refersto a chemical group that is bonded covalently to a solid support and isattached between the support and the substrate typically in order topermit the release (cleavage) of the substrate from the solid support.However, it can also be used to impart stability to the bond to thesolid support or merely as a spacer element. Many solid supports areavailable commercially with linkers already attached.

Abbreviations used for amino acids and designation of peptides followthe rules of the IUPAC-IUB Commission of Biochemical Nomenclature in J.Biol. Chem. 1972, 247, 977-983. This document has been updated: Biochem.J., 1984, 219, 345-373; Eur. J. Biochem., 1984, 138, 9-37; 1985, 152, 1;Internat. J. Pept. Prot. Res., 1984, 24, following p 84; J. Biol. Chem.,1985, 260, 14-42; Pure Appl. Chem., 1984, 56, 595-624; Amino Acids andPeptides, 1985, 16, 387-410; and in Biochemical Nomenclature and RelatedDocuments, 2nd edition, Portland Press, 1992, pp 39-67. Extensions tothe rules were published in the JCBN/NC-IUB Newsletter 1985, 1986, 1989;see Biochemical Nomenclature and Related Documents, 2nd edition,Portland Press, 1992, pp 68-69.

The term “effective amount” or “effective” is intended to designate adose that causes a relief of symptoms of a disease or disorder as notedthrough clinical testing and evaluation, patient observation, and/or thelike, and/or a dose that causes a detectable change in biological orchemical activity. The detectable changes may be detected and/or furtherquantified by one skilled in the art for the relevant mechanism orprocess. As is generally understood in the art, the dosage will varydepending on the administration routes, symptoms and body weight of thepatient but also depending upon the compound being administered.

Administration of two or more compounds “in combination” means that thetwo compounds are administered closely enough in time that the presenceof one alters the biological effects of the other. The two compounds canbe administered simultaneously (concurrently) or sequentially.Simultaneous administration can be carried out by mixing the compoundsprior to administration, or by administering the compounds at the samepoint in time but at different anatomic sites or using different routesof administration. The phrases “concurrent administration”,“administration in combination”, “simultaneous administration” or“administered simultaneously” as used herein, means that the compoundsare administered at the same point in time or immediately following oneanother. In the latter case, the two compounds are administered at timessufficiently close that the results observed are indistinguishable fromthose achieved when the compounds are administered at the same point intime.

The term “pharmaceutically active metabolite” is intended to mean apharmacologically active product produced through metabolism in the bodyof a specified compound.

The term “solvate” is intended to mean a pharmaceutically acceptablesolvate form of a specified compound that retains the biologicaleffectiveness of such compound. Examples of solvates, withoutlimitation, include compounds of the invention in combination withwater, isopropanol, ethanol, methanol, DMSO, ethyl acetate, acetic acid,or ethanolamine.

1. Compounds

Novel macrocyclic compounds of the present invention include macrocycliccompounds comprising a building block structure including a tethercomponent that undergoes cyclization to form the macrocyclic compound.The building block stricture can comprise amino acids (standard andunnatural), hydroxy acids, hydrazino acids, aza-amino acids, specializedmoieties such as those that play a role in the introduction of peptidesurrogates and isosteres, and a tether component as described herein.The tether component can be selected from the following:

wherein (Z₂) is the site of a covalent bond of T to Z₂, and Z₂ is asdefined below for formula I, and wherein (X) is the site of a covalentbond of T to X, and X is as defined below for formula I; L₇ is —CH₂— or—O—; U₁ is —CR₁₀₁R₁₀₂— or —C(═O)—; R₁₀₀ is lower alkyl; R₁₀₁ and R₁₀₂are each independently hydrogen, lower alkyl or substituted lower alkyl;xx is 2 or 3; yy is 1 or 2; zz is 1 or 2; and aaa is 0 or 1.

Macrocyclic compounds of the present invention further include those offormula I, formula II and/or formula III:

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof,

wherein:

R₁ is hydrogen or the side chain of an amino acid, or alternatively R₁and R₂ together form a 4-, 5-, 6- or 7-membered ring, optionallycomprising an O, S or N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below, or alternatively R₁ and R₉together form a 3-, 4-, 5-, 6- or 7-membered ring, optionally comprisingan O, S or additional N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below;

R₂ is hydrogen or the side chain of an amino acid, or alternatively, R₁and R₂ together form a 4-, 5-, 6- or 7-membered ring, optionallycomprising an O, S or N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below; or alternatively R₂ and R₉together form a 3-, 4-, 5-, 6- or 7-membered ring, optionally comprisingan O, S or additional N atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below;

R₃ is hydrogen or the side chain of an amino acid, or alternatively R₃and R₄ together form a 3-, 4-, 5-, 6- or 7-membered ring, optionallycomprising an O or S atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below, or alternatively, R₃ and R₇ or R₃and R₁₁ together form a 4-, 5-, 6-, 7- or 8-membered heterocyclic ring,optionally comprising an O, S or additional N atom in the ring, whereinthe ring is optionally substituted with R₈ as defined below;

R₄ is hydrogen or the side chain of an amino acid, or alternatively R₄and R₃ together form a 3-, 4-, 5-, 6- or 7-membered ring, optionallycomprising an O or S atom in the ring, wherein the ring is optionallysubstituted with R₈ as defined below, or alternatively R₄ and R₇ or R₄and R₁₁ together form a 4-, 5-, 6-, 7- or 8-membered heterocyclic ring,optionally comprising an O, S or additional N atom in the ring, whereinthe ring is optionally substituted with R₈ as defined below;

R₅ and R₆ are each independently hydrogen or the side chain of an aminoacid or alternatively R₅ and R₆ together form a 3-, 4-, 5-, 6- or7-membered ring, optionally comprising an O, S or N atom in the ring,wherein the ring is optionally substituted with R₈ as defined below;

R₇ is hydrogen, lower alkyl, substituted lower alkyl, cycloalkyl,substituted cycloalkyl, a heterocyclic group, or a substitutedheterocyclic group, or alternatively R₃ and R₇ or R₄ and R₇ togetherform a 3-, 4-, 5-, 6-, 7- or 8-membered heterocyclic ring optionallycomprising an O, S or additional N atom in the ring, wherein the ring isoptionally substituted with R₈ as described below;

R₈ is substituted for one or more hydrogen atoms on the 3-, 4-, 5-, 6-,7- or 8-membered ring structure and is independently selected from thegroup consisting of alkyl, substituted alkyl, cycloalkyl, substitutedcycloalkyl, a heterocyclic group, a substituted heterocyclic group,aryl, substituted aryl, heteroaryl, substituted heteroaryl, hydroxy,alkoxy, aryloxy, oxo, amino, halogen, formyl, acyl, carboxy,carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino, ureido, amidino,mercapto, sulfinyl, sulfonyl and sulfonamido, or, alternatively, R₈ is afused cycloalkyl, a substituted fused cycloalkyl, a fused heterocyclic,a substituted fused heterocyclic, a fused aryl, a substituted fusedaryl, a fused heteroaryl or a substituted fused heteroaryl ring whensubstituted for hydrogen atoms on two adjacent atoms;

X is O, NR₉ or N(R₁₀)₂;

-   -   wherein R₉ is hydrogen, lower alkyl, substituted lower alkyl,        sulfonyl, sulfonamido or amidino and R₁₀ is hydrogen, lower        alkyl, or substituted lower alkyl, or alternatively R₉ and R₁        together form a 3-, 4-, 5-, 6- or 7-membered ring, optionally        comprising an O, S or additional N atom in the ring, wherein the        ring is optionally substituted with R₈ as defined above;

Z₁ is O or NR₁₁,

-   -   wherein R₁₁ is hydrogen, lower alkyl, or substituted lower        alkyl, or alternatively R₃ and R₁₁ together or R₄ and R₁₁        together form a 4-, 5-, 6-, 7- or 8-membered heterocyclic ring,        optionally comprising an O, S or additional N atom in the ring,        wherein the ring is optionally substituted with R₈ as defined        above;

Z₂ is O or NR₁₂, wherein R₁₂ is hydrogen, lower alkyl, or substitutedlower alkyl;

m, n and p are each independently 0, 1 or 2;

T is a bivalent radical of formula IV:—U—(CH₂)_(d)—W—Y—Z—(CH₂)_(e)—  (IV)

-   -   wherein d and e are each independently 0, 1, 2, 3, 4 or 5; Y and        Z are each optionally present; U is —CR₂₁R₂₂— or —C(═O)— and is        bonded to X of formula I; W, Y and Z are each independently        selected from the group consisting of —O—, —NR₂₃—, —S—, —SO—,        —SO₂—, —C(═O)—O—, —O—C(═O)—, C(═O)—NH—, —NH—C(═O)—, —SO₂—NH—,        —NH—SO₂—, —CR₂₄R₂₅—, —CH═CH— with the configuration Z or E, —C≡C        and the ring structures below:

-   -   -   wherein G₁ and G₂ are each independently a covalent bond or            a bivalent radical selected from the group consisting of            —O—, —NR₃₉—, —S—, —SO—, —SO₂—, —C(═O)—, —C(═O)—O—,            —O—C(═O)—, —C(═O)NH—, —NH—C(═O)—, —SO₂—NH—, —NH—SO₂—,            —CR₄₀R₄₁—, —CH═CH— with the configuration Z or E, and —C≡C—;            with GI being bonded closest to the group U, wherein any            carbon atom in the rings not otherwise defined, can be            replaced by N, with the proviso that the ring cannot contain            more than four N atoms; K₁, K₂, K₃, K₄ and K₅ are each            independently O, NR₄₂ or S, wherein R₄₂ is as defined below;        -   R₂₁ and R₂₂ are each independently hydrogen, lower alkyl, or            substituted lower alkyl, or alternatively R₂₁ and R₂₂            together form a 3- to 12-membered cyclic ring optionally            comprising one or more heteroatoms selected from the group            consisting of O, S and N, wherein the ring is optionally            substituted with R₈ as defined above;        -   R₂₃, R₃₉ and R₄₂ are each independently hydrogen, alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl,            heterocyclic, substituted heterocyclic, aryl, substituted            aryl, heteroaryl, substituted heteroaryl, formyl, acyl,            carboxyalkyl, carboxyaryl, amido, amidino, sulfonyl or            sulfonamido;        -   R₂₄ and R₂₅ are each independently hydrogen, lower alkyl,            substituted lower alkyl, R_(AA), wherein R_(AA) is a side            chain of an amino acid such as a standard or unusual amino            acid, or alternatively R₂₄ and R₂₅ together form a 3- to            12-membered cyclic ring optionally comprising one or more            heteroatoms selected from the group consisting of O, S and            N; or alternatively one of R₂₄ or R₂₅ is hydroxy, alkoxy,            aryloxy, amino, mercapto, carbamoyl, amidino, ureido or            guanidino while the other is hydrogen, lower alkyl or            substituted lower alkyl, except when the carbon to which R₂₄            and R₂₅ are bonded is also bonded to another heteroatom;        -   R₂₆, R₃₁, R₃₅ and R₃₈ are each optionally present and, when            present, are substituted for one or more hydrogen atoms on            the indicated ring and each is independently selected from            the group consisting of halogen, trifluoromethyl, alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl, a            heterocyclic group, a substituted heterocyclic group, aryl,            substituted aryl, heteroaryl, substituted heteroaryl,            hydroxy, alkoxy, aryloxy, amino, formyl, acyl, carboxy,            carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino,            ureido, amidino, cyano, nitro, mercapto, sulfinyl, sulfonyl            and sulfonamido;        -   R₂₇ is optionally present and is substituted for one or more            hydrogen atoms on the indicated ring and each is            independently selected from the group consisting of alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl, a            heterocyclic group, a substituted heterocyclic group, aryl,            substituted aryl, heteroaryl, substituted heteroaryl,            hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl, carboxy,            carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino,            ureido, amidino, mercapto, sulfinyl, sulfonyl and            sulfonamido;        -   R₂₈, R₂₉, R₃₀, R₃₂, R₃₃, R₃₄, R₃₆ and R₃₇ are each            optionally present and, when no double bond is present to            the carbon atom to which it is bonded in the ring, two            groups are optionally present, and when present, is            substituted for one hydrogen present in the ring, or when no            double bond is present to the carbon atom to which it is            bonded in the ring, is substituted for one or both of the            two hydrogen atoms present on the ring and each is            independently selected from the group consisting of alkyl,            substituted alkyl, cycloalkyl, substituted cycloalkyl, a            heterocyclic group, a substituted heterocyclic group, aryl,            substituted aryl, heteroaryl, substituted heteroaryl,            hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl, carboxy,            carboxyalkyl, carboxyaryl, amido, carbamoyl, guanidino,            ureido, amidino, mercapto, sulfinyl, sulfonyl, sulfonamido            and, only if a double bond is present to the carbon atom to            which it is bonded, halogen; and        -   R₄₀ and R₄₁ are each independently hydrogen, lower alkyl,            substituted lower alkyl, R_(AA) as defined above, or            alternatively R₄₀ and R₄₁ together form a 3- to 12-membered            cyclic ring optionally comprising one or more heteroatoms            selected from the group consisting of O, S and N wherein the            ring is optionally substituted with R₈ as defined above, or            alternatively one of R₄₀ and R₄₁ is hydroxy, alkoxy,            aryloxy, amino, mercapto, carbamoyl, amidino, ureido or            guanidino, while the other is hydrogen, lower alkyl or            substituted lower alkyl, except when the carbon to which R₄₀            and R₄₁ are bonded is also bonded to another heteroatom;

    -   with the proviso that T is not an amino acid residue, dipeptide        fragment, tripeptide fragment or higher order peptide fragment        including standard amino acids;

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof,wherein:

R₅₀ is —(CH₂)_(ss)CH₃, —CH(CH₃)(CH₂)_(tt)CH₃, —(CH₂)_(uu)CH(CH₃)₂,—C(CH₃)₃, —(CHR₅₅)_(vv)—R₅₆, or —CH(OR₅₇)CH₃, wherein ss is 1, 2 or 3;tt is 1 or 2; uu is 0, 1 or 2; and vv is 0, 1, 2, 3 or 4; R₅₅ ishydrogen or C₁-C₄ alkyl; R₅₆ is amino, hydroxy, alkoxy, cycloalkyl orsubstituted cycloalkyl; and R₅₇ is hydrogen, alkyl, acyl, amino acyl,sulfonyl, carboxyalkyl or carboxyaryl;

R₅₁ is hydrogen, C₁-C₄ alkyl or C₁-C₄ alkyl substituted with hydroxy oralkoxy;

R₅₂ is —(CHR₅₈)_(ww)R₅₉, wherein ww is 0, 1, 2 or 3; R₅₈ is hydrogen,C₁-C₄ alkyl, amino, hydroxy or alkoxy; R₅₉ is aryl, substituted aryl,heteroaryl, substituted heteroaryl, cycloalkyl or substitutedcycloalkyl;

R₅₃ is hydrogen or C₁-C₄ alkyl;

X₂ is O, NR₉ or N(R₁₀)₂ ⁺;

-   -   wherein R₉ is hydrogen, lower alkyl, substituted lower alkyl,        sulfonyl, sulfonamido or amidino and R₁₀ is hydrogen, lower        alkyl, or substituted lower alkyl;

Z₅ is O or NR₁₂, wherein R₁₂ is hydrogen, lower alkyl, or substitutedlower alkyl; and

T₂ is a bivalent radical of formula V:U_(a)—(CH₂)_(d)—W_(a)—Y_(a)—Z_(a)—(CH₂)_(e)—  (V)

-   -   wherein d and e are independently 0, 1, 2, 3, 4 or 5; Y_(a) and        Z_(a) are each optionally present; U_(a) is —CR₆OR₆₁— or —C(═O)—        and is bonded to X₂ of formula II, wherein R₆₀ and R₆, are each        independently hydrogen, lower alkyl, or substituted lower alkyl,        or alternatively R₂₁ and R₂₂ together form a 3- to 12-membered        cyclic ring optionally comprising one or more heteroatoms        selected from the group consisting of O, S and N, wherein the        ring is optionally substituted with R₈ as defined above; W_(a),        Y_(a) and Z_(a) are each independently selected from the group        consisting of: —O—, —NR₆₂—, —S—, —SO—, —SO₂—, —C(═O)O—,        —O—C(═O)—, —C(═O)—NH—, —NH—C(═O)—, —SO₂—NH—, —NH—SO₂—,        —CR₆₃R₆₄—, —CH═CH— with the configuration Z or E, —C≡C—, and the        ring structures depicted below:

-   -   -   wherein G₁ and G₂ are defined above, and wherein any carbon            atom in the ring is optionally replaced by N, with the            proviso that the aromatic ring cannot contain more than four            N atoms and the cycloalkyl ring cannot contain more than two            N atoms;            -   R₆₂ is hydrogen, alkyl, substituted alkyl, cycloalkyl,                substituted cycloalkyl, a heterocyclic group, a                substituted heterocyclic group, aryl, substituted aryl,                heteroaryl, substituted heteroaryl, formyl, acyl,                carboxyalkyl, carboxyaryl, amido, amidino, sulfonyl or                sulfonamido;            -   R₆₃ and R₆₄ are each independently hydrogen, lower                alkyl, substituted lower alkyl or R_(AA); or                alternatively R₆₃ and R₆₄ together form a 3- to                12-membered cyclic ring optionally comprising one or                more heteroatoms selected from the group consisting of                O, S and N; or alternatively one of R₆₃ and R₆₄ is                hydroxy, alkoxy, aryloxy, amino, mercapto, carbamoyl,                amidino, ureido or guanidino, while the other is                hydrogen, lower alkyl or substituted lower alkyl, except                when the carbon to which R₆₃ and R₆₄ are bonded is also                bonded to another heteroatom; and R_(AA) indicates the                side chain of a standard or unusual amino acid;            -   R₆₅ and R₆₈ are each optionally present, and, when                present are substituted for one or more hydrogen atoms                on the ring and each is independently halogen,                trifluoromethyl, alkyl, substituted alkyl, cycloalkyl,                substituted cycloalkyl, a heterocyclic group, a                substituted heterocyclic group, aryl, substituted aryl,                heteroaryl, substituted heteroaryl, hydroxy, alkoxy,                aryloxy, amino, formyl, acyl, carboxy, carboxyalkyl,                carboxyaryl, amido, carbamoyl, guanidino, ureido,                amidino, cyano, nitro, mercapto, sulfinyl, sulfonyl or                sulfonamido;            -   R₆₆ and R₆₇ are each optionally present, and when no                double bond is present to the carbon atom to which it is                bonded in the ring, two groups are optionally present,                and, when present, each is substituted for one hydrogen                present in the ring, or when no double bond is present                to the carbon atom to which it is bonded in the ring, is                substituted for one or both of the two hydrogen atoms                present on the ring and each is independently alkyl,                substituted alkyl, cycloalkyl, substituted cycloalkyl,                heterocyclic, substituted heterocyclic, aryl,                substituted aryl, heteroaryl, substituted heteroaryl,                hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl,                carboxy, carboxyalkyl, carboxyaryl, amido, carbamoyl,                guanidino, ureido, amino, mercapto, sulfinyl, sulfonyl,                sulfonamide and, only if a double bond is present to the                carbon atom to which it is bonded, halogen;            -   R₆₉ is optionally present, and when present is                substituted for one or more hydrogen atoms on the ring                and each is independently alkyl, substituted alkyl,                cycloalkyl, substituted cycloalkyl, a heterocyclic                group, a substituted heterocyclic group, aryl,                substituted aryl, heteroaryl, substituted heteroaryl,                hydroxy, alkoxy, aryloxy, oxo, amino, formyl, acyl,                carboxy, carboxyalkyl, carboxyaryl, amido, carbamoyl,                guanidino, ureido, amidino, mercapto, sulfinyl, sulfonyl                or sulfonamido;            -   K₆ is O or S; and            -   ff is 1, 2, 3, 4 or 5;

    -   with the proviso that T₂ is not an amino acid residue, dipeptide        fragment, tripeptide fragment or higher order peptide fragment        including standard amino acids; or

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof, wherein:

R₇₀ is hydrogen, C₁-C₄ alkyl or alternatively R₇₀ and R₇₁ together forma 3-, 4-, 5-, 6- or 7-membered ring, optionally comprising an O, N or Satom in the ring, wherein the ring is optionally substituted with R_(8a)as defined below;

R₇₁ is hydrogen, —(CH₂)_(aa)CH₃, —CH(CH₃)(CH₂)_(bb)CH₃,—(CH₂)_(cc)CH(CH₃)₂, —(CH₂)_(dd)—R₇₆ or —CH(OR₇₇)CH₃ or, alternativelyR₇₁ and R₇₀ together form a 3-, 4-, 5-, 6- or 7-membered ring,optionally comprising an O, N or S atom in the ring, wherein the ring isoptionally substituted with R_(8a) as defined below; wherein aa is 0, 1,2, 3, 4 or 5; bb is 1, 2 or 3; cc is 0, 1, 2 or 3; and dd is 0, 1, 2, 3or 4; R₇₆ is aryl, substituted aryl, heteroaryl, substituted heteroaryl,cycloalkyl or substituted cycloalkyl; R₇₇ is hydrogen, alkyl, acyl,amino acyl, sulfonyl, carboxyalkyl or carboxyaryl;

R₇₂ is C₁-C₄ alkyl, or alternatively R₇₂ and R₇₃ together form a 3-, 4-,5-, 6- or 7-membered ring, optionally comprising an O or S atom in thering, wherein the ring is optionally substituted with R_(8b) as definedbelow;

R₇₃ is hydrogen, or alternatively R₇₃ and R₇₂ together form a 3-, 4-,5-, 6- or 7-membered ring, optionally comprising an O, S or N atom inthe ring, wherein the ring is optionally substituted with R_(8b) asdefined below;

R₇₄ is hydrogen or C₁-C₄ alkyl or alternatively R₇₄ and R₇₅ togetherform a 3-, 4-, 5-, 6- or 7-membered ring, optionally comprising an O, Nor S atom in the ring, wherein the ring is optionally substituted withR_(8c) as defined below;

R₇₅ is —(CHR₇₈)R₇₉ or alternatively R₇₅ and R₇₄ together form a 3-, 4-,5-, 6- or 7-membered ring, optionally comprising an O, N or S atom inthe ring, wherein the ring is optionally substituted with R_(8c) asdefined below; wherein R₇₈ is hydrogen, C₁-C₄ alkyl, amino, hydroxy oralkoxy, and R₇₉ is selected from the group consisting of the followingstructures:

-   -   wherein E₁, E₂, E₃, E₄ and E₅ are each optionally present and        when present are each independently selected from the group        consisting of halogen, trifluoromethyl, alkyl, substituted        alkyl, cycloalkyl, substituted cycloalkyl, a heterocyclic group,        a substituted heterocyclic group, aryl, substituted aryl,        heteroaryl, substituted heteroaryl, hydroxy, alkoxy, aryloxy,        cyano, sulfinyl, sulfonyl and sulfonamido, and represent        substitution at one or more available positions on the        monocyclic or bicyclic aromatic ring, wherein said substitution        is made with the same or different selected group member, and J₁        and J₂ are each independently O or S;

R_(8a), R_(8b) and R_(8c) are each independently substituted for one ormore hydrogen atoms on the 3-, 4-, 5-, 6- or 7-membered ring structureand are independently selected from the group consisting of alkyl,substituted alkyl, cycloalkyl, substituted cycloalkyl, a heterocyclicgroup, a substituted heterocyclic group, aryl, substituted aryl,heteroaryl, substituted heteroaryl, hydroxy, alkoxy, aryloxy, oxo,amino, halogen, formyl, acyl, carboxy, carboxyalkyl, carboxyaryl, amido,carbamoyl, guanidino, ureido, amidino, mereapto, sulfinyl, sulfonyl andsulfonamido, or, alternatively, R_(8a), R_(8b) and R_(8c) are eachindependently a fused cycloalkyl, a substituted fused cycloalkyl, afused heterocyclic, a substituted fused heterocyclic, a fused aryl, asubstituted fused aryl, a fused heteroaryl or a substituted fusedheteroaryl ring when substituted for hydrogen atoms on two adjacentatoms;

X₃ is O, NR₉ or N(R₁₀)₂ ⁺;

-   -   wherein R₉ is hydrogen, lower alkyl, substituted lower alkyl,        sulfonyl, sulfonamido or amidino and R₁₀ is hydrogen, lower        alkyl, or substituted lower alkyl;

Z₁₀ is O or NR₁₂, wherein R₁₂ is hydrogen, lower alkyl, or substitutedlower alkyl; and

T₃ is the same as defined for T₂ with the exception that U_(a) is bondedto X₃ of formula III.

In some embodiments of the present invention, the compound can have oneof the following structures:

or an optical isomer, enantiomer, diastereomer, racemate orstereochemical mixture thereof.

The present invention includes isolated compounds. An isolated compoundrefers to a compound that, in some embodiments, comprises at least 10%,at least 25%, at least 50% or at least 70% of the compounds of amixture. In some embodiments, the compound, pharmaceutically acceptablesalt thereof or pharmaceutical composition containing the compoundexhibits a statistically significant binding and/or antagonist activitywhen tested in biological assays at the human ghrelin receptor.

In the case of compounds, salts, or solvates that are solids, it isunderstood by those skilled in the art that the inventive compounds,salts, and solvates may exist in different crystal or polymorphic forms,all of which are intended to be within the scope of the presentinvention and specified formulas.

The compounds of formula I, II and/or III disclosed herein haveasymmetric centers. The inventive compounds may exist as singlestereoisomers, racemates, and/or mixtures of enantiomers and/ordiastereomers. All such single stereoisomers, racemates, and mixturesthereof are intended to be within the scope of the present invention. Inparticular embodiments, however, the inventive compounds are used inoptically pure form. The terms “S” and “R” configuration as used hereinare as defined by the IUPAC 1974 Recommendations for Section E,Fundamentals of Stereochemistry (Pure Appl. Chem. 1976, 45, 13-30.)

Unless otherwise depicted to be a specific orientation, the presentinvention accounts for all stereoisomeric forms. The compounds may beprepared as a single stereoisomer or a mixture of stereoisomers. Thenon-racemic forms may be obtained by either synthesis or resolution. Thecompounds may, for example, be resolved into the component enantiomersby standard techniques, for example formation of diastereomeric pairsvia salt formation. The compounds also may be resolved by covalentlybonding to a chiral moiety. The diastereomers can then be resolved bychromatographic separation and/or crystallographic separation. In thecase of a chiral auxiliary moiety, it can then be removed. As analternative, the compounds can be resolved through the use of chiralchromatography. Enzymatic methods of resolution could also be used incertain cases.

As generally understood by those skilled in the art, an “optically pure”compound is one that contains only a single enantiomer. As used herein,the term “optically active” is intended to mean a compound comprising atleast a sufficient excess of one enantiomer over the other such that themixture rotates plane polarized light. Optically active compounds havethe ability to rotate the plane of polarized light. The excess of oneenantiomer over another is typically expressed as enantiomeric excess(e.e.). In describing an optically active compound, the prefixes D and Lor R and S are used to denote the absolute configuration of the moleculeabout its chiral center(s). The prefixes “d” and “1” or (+) and (−) areused to denote the optical rotation of the compound (i.e., the directionin which a plane of polarized light is rotated by the optically activecompound). The “1” or (−) prefix indicates that the compound islevorotatory (i.e., rotates the plane of polarized light to the left orcounterclockwise) while the “d” or (+) prefix means that the compound isdextrarotatory (i.e., rotates the plane of polarized light to the rightor clockwise). The sign of optical rotation, (−) and (+), is not relatedto the absolute configuration of the molecule, R and S.

A compound of the invention having the desired pharmacologicalproperties will be optically active and, can be comprised of at least90% (80% e.e.), at least 95% (90% e.e.), at least 97.5% (95% e.e.) or atleast 99% (98% e.e.) of a single isomer.

Likewise, many geometric isomers of double bonds and the like can alsobe present in the compounds disclosed herein, and all such stableisomers are included within the present invention unless otherwisespecified. Also included in the invention are tautomers and rotamers offormula I, II and/or III.

The use of the following symbols at the right refers to substitution ofone or more hydrogen atoms of the indicated ring with the definedsubstituent R.

The use of the following symbol indicates a single bond or an optionaldouble bond:

Embodiments of the present invention further provide intermediatecompounds formed through the synthetic methods described herein toprovide the compounds of formula I, II and/or III. The intermediatecompounds may possess utility as a therapeutic agent for the range ofindications described herein and/or a reagent for further synthesismethods and reactions.

2. Synthetic Methods

The compounds of formula I, II and/or II can be synthesized usingtraditional solution synthesis techniques or solid phase chemistrymethods. In either, the constriction involves four phases: first,synthesis of the building blocks comprising recognition elements for thebiological target receptor, plus one tether moiety, primarily forcontrol and definition of conformation. These building blocks areassembled together, typically in a sequential fashion, in a second phaseemploying standard chemical transformations. The precursors from theassembly are then cyclized in the third stage to provide the macrocyclicstructures. Finally, the post-cyclization processing fourth stageinvolving removal of protecting groups and optional purificationprovides the desired final compounds. Synthetic methods for this generaltype of macrocyclic structure are described in Intl. Pat. Appls. WO01/25257, WO 2004/111077, WO 2005/012331 and WO 2005/012332, includingpurification procedures described in WO 2004/111077 and WO 2005/012331.

In some embodiments of the present invention, the macrocyclic compoundsof formula I, II and/or III may be synthesized using solid phasechemistry on a soluble or insoluble polymer matrix as previouslydefined. For solid phase chemistry, a preliminary stage involving theattachment of the first building block, also termed “loading,” to theresin must be performed. The resin utilized for the present inventionpreferentially has attached to it a linker moiety, L. These linkers areattached to an appropriate free chemical functionality, usually analcohol or amine, although others are also possible, on the base resinthrough standard reaction methods known in the art, such as any of thelarge number of reaction conditions developed for the formation of esteror amide bonds. Some linker moieties for the present invention aredesigned to allow for simultaneous cleavage from the resin withformation of the macrocycle in a process generally termed“cyclization-release.” (van Maarseveen, J. H. Solid phase synthesis ofheterocycles by cyclization/cleavage methodologies. Comb. Chem. HighThroughput Screen. 1998, 1, 185-214; Ian W. James, Linkers for solidphase organic synthesis. Tetrahedron 1999, 55, 4855-4946; Eggenweiler,H.-M. Linkers for solid-phase synthesis of small molecules: coupling andcleavage techniques. Drug Discovery Today 1998, 3, 552-560; Backes, B.J.; Ellman, J. A. Solid support linker strategies. Curr. Opin. Chem.Biol. 1997, 1, 86-93. Of particular utility in this regard for compoundsof the invention is the 3-thiopropionic acid linker. (Hojo, H.; Aimoto,S. Bull. Chem. Soc. Jpn. 1991, 64, 111-117; Zhang, L.; Tam, J. J. Am.Chem. Soc. 1999, 121, 3311-3320.)

Such a process provides material of higher purity as only cyclicproducts are released from the solid support and no contamination withthe linear precursor occurs as would happen in solution phase. Aftersequential assembly of all the building blocks and tether into thelinear precursor using known or standard reaction chemistry,base-mediated intramolecular attack on the carbonyl attached to thislinker by an appropriate nucleophilic functionality that is part of thetether building block results in formation of the amide or ester bondthat completes the cyclic structure as shown (Scheme 1). An analogousmethodology adapted to solution phase can also be applied as wouldlikely be preferable for larger scale applications.

Although this description accurately represents the pathway for one ofthe methods of the present invention, the thioester strategy, anothermethod of the present invention, that of ring-closing metathesis (RCM),proceeds through a modified route where the tether component is actuallyassembled during the cyclization step. However, in the RCM methodologyas well, assembly of the building blocks proceeds sequentially, followedby cyclization (and release from the resin if solid phase). Anadditional post-cyclization processing step is required to removeparticular byproducts of the RCM reaction, but the remaining subsequentprocessing is done in the same manner as for the thioester or analogousbase-mediated cyclization strategy.

Moreover, it will be understood that steps including the methodsprovided herein may be performed independently or at least two steps maybe combined. Additionally, steps including the methods provided herein,when performed independently or combined, may be performed at the sametemperature or at different temperatures without departing from theteachings of the present invention.

Novel macrocyclic compounds of the present invention include thoseformed by a novel process including cyclization of a building blockstructure to form a macrocyclic compound comprising a tether componentdescribed herein. Accordingly, the present invention provides methods ofmanufacturing the compounds of the present invention comprising (a)assembling building block structures, (b) chemically transforming thebuilding block structures, (c) cyclizing the building block structuresincluding a tether component, (d) removing protecting groups from thebuilding block structures, and (e) optionally purifying the productobtained from step (d). In some embodiments, assembly of the buildingblock structures may be sequential. In further embodiments, thesynthesis methods are carried out using traditional solution synthesistechniques or solid phase chemistry techniques.

A. Amino Acids

Amino acids, Boc- and Fmoc-protected amino acids and side chainprotected derivatives, including those of N-methyl and unnatural aminoacids, were obtained from commercial suppliers [for example AdvancedChemTech (Louisville, Ky., USA), Bachem (Bubendorf, Switzerland),ChemImpex (Wood Dale, Ill., USA), Novabiochem (subsidiary of Merck KGaA,Darmstadt, Germany), PepTech (Burlington, Mass., USA), Synthetech(Albany, Oreg., USA)] or synthesized through standard methodologiesknown to those in the art. Ddz-amino acids were either obtainedcommercially from Orpegen (Heidelberg, Germany) or Advanced ChemTech(Louisville, Ky., USA) or synthesized using standard methods utilizingDdz-OPh or Ddz-N₃. (Birr, C.; Lochinger, W.; Stahnke, G.; Lang, P. Theα,α-dimethyl-3,5-dimethoxybenzyloxycarbonyl (Ddz) residue, anN-protecting group labile toward weak acids and irradiation. JustusLiebigs Ann. Chem. 1972, 763, 162-172.) Bts-amino acids were synthesizedby known methods. (Vedejs, E.; Lin, S.; Klapara, A.; Wang, J.“Heteroarene-2-sulfonyl Chlorides (BtsCl, ThsCl): Reagents for NitrogenProtection and >99% Racemization-Free Phenylglycine Activation withSOCl₂ .” J. Am. Chem. Soc. 1996, 118, 9796-9797. Also WO 01/25257, WO2004/111077) N-Alkyl amino acids, in particular N-methyl amino acids,are commercially available from multiple vendors (Bachem, Novabiochem,Advanced ChemTech, ChemImpex). In addition, N-alkyl amino acidderivatives were accessed via literature methods. (Hansen, D. W., Jr.;Pilipauskas, D. J. Org. Chem. 1985, 50, 945-950.)

B. Tethers

Tethers were obtained from the methods previously described in Intl.Pat. Appl. WO 01/25257, WO 2004/111077, WO 2005/012331 and U.S.Provisional Patent Application Ser. No. 60/622,055. Procedures forsynthesis of tethers as described herein are presented in the Examplesbelow. Exemplary tethers (T) include, but are not limited to, thefollowing:

and intermediates in the manufacture thereof, wherein (Z) is the site ofa covalent bond of T to Z₂, Z₅ or Z₁₀ and Z₂, Z₅ and Z₁₀ are definedabove for formula I, II and III, respectively, and wherein (X) is thesite of a covalent bond of T to X, X₂ or X₃ and X, X₂ and X₃ are definedabove for formula I; II and III, respectively, L₇ is —CH₂— or —O—; U₁ is—CR₁₀₁R₁₀₂— or —C(═O)—; R₁₀₀ is lower alkyl; R₁₀₁ and R₁₀₂ are eachindependently hydrogen, lower alkyl or substituted lower alkyl; xx is 2or 3; yy is 1 or 2; zz is 1 or 2; and aaa is 0 or 1.C. Solid Phase Techniques

Specific solid phase techniques for the synthesis of the macrocycliccompounds of the invention have been described in WO 01/25257, WO2004/111077, WO 2005/012331 and WO 2005/012332. Solution phase synthesisroutes, including methods amenable to larger scale manufacture, weredescribed in U.S. Provisional Patent Application Ser. Nos. 60/622,055and 60/642,271.

In certain cases, however, the lability of protecting groups precludedthe use of the standard basic medium for cyclization in the thioesterstrategy discussed above. In these cases, either of two acidic methodswas employed to provide macrocyclization under acid conditions. Onemethod utilized HOAc, while the other method employed HOAt (Scheme 2).For example, the acetic acid cyclization was used for compound 219.

After executing the deprotection of the Ddz or Boc group on the tether,the resin was washed sequentially with DCM (2×), DCM-MeOH (1:1, 2×), DCM(2×), and DIPEA-DCM (3:7, 1×). The resin was dried under vacuum for 10min, then added immediately to a solution of HOAc in degassed DMF (5%v/v). The reaction mixture was agitated at 50-70° C. O/N. The resin wasfiltered, washed with THF, and the combined filtrate and washesevaporated tinder reduced pressure (water aspirator, then oil pump) toafford the macrocycle.

For a representative macrocycle with tether T1, AA₃=Leu, AA₂=Leu,AA₁=Phe, the application of the HOAt method shown in Scheme 2 providedthe cyclic peptidomimetic in 10% yield, while the acetic acid method wasmore effective, and gave 24% overall yield of the same macrocycle. Thislatter methodology was particularly effective for compounds containingHis(Mts) residues. For example, with tether T8, AA₃=Phe, AA₂=Acp,AA₁=His(Mts), the macrocycle was obtained in 20% overall yield, but themajority of the product no longer had the Mts group on histidine (15:1versus still protected).

Synthesis of representative macrocyclic compounds of the presentinvention are shown in the Examples below. Table 1A below presents asummary of the synthesis of 228 representative compounds of the presentinvention. The reaction methodology employed for the construction of themacrocyclic molecule is indicated in Column 2 and relates to theparticular scheme of the synthetic strategy, for example, use of thethioester strategy as shown in FIG. 2 or the RCM approach as shown inFIG. 3. Column 3 indicates if any substituents are present on N_(BB1).Columns 4-6 and 8 indicate the individual building blocks employed foreach compound, amino acids, hydroxy acids or tether utilizing eitherstandard nomenclature or referring to the building block designationspresented elsewhere in this application. Column 7 indicates the methodused for attachment of the tether, either a Mitsunobu reaction(previously described in WO 01/25257) or reductive amination (previouslydescribed in WO 2004/111077). The relevant deprotection and couplingprotocols as appropriate for the nature of the building block employstandard procedures and those described in WO 2004/111077 for theassembly of the cyclization precursors. The building blocks are listedin the opposite order from which they are added in order to correlatethe building block number with standard peptide nomenclature. Hence BB₃is added first, followed by BB₂, then BB₁, finally the tether (T). Inthe case of the RCM, the tether is not formed completely until thecyclization step, but the portion of the tether attached to BB₁ is stilladded at this stage of the sequence. The final macrocycles are obtainedafter application of the appropriate deprotection sequences. If anyreaction was required to be carried out post-cyclization, it is listedin Column 9. All of the macrocycles presented in Table 1A were purifiedand met internal acceptance criteria. Yields (Column 10) are eitherisolated or as calculated based upon CLND analysis. It should be notedthat compounds 58 and 99 were not cyclized to provide the linearanalogues of compounds 10 and 133, respectively. The lack of bindingpotency observed with these linear analogues illustrates the importanceof the macrocyclic structural feature for the desired activity.

TABLE 1A Synthesis of Representative Compounds of the Present InventionMacrocyclic Compound Assembly Method N_(BB1)-R BB₁ BB₂ BB₃ 1 ThioesterStrategy H Bts-Nle Boc-Sar Boc-(D)Phe 2 Thioester Strategy H Bts-IleBoc-(D)Ala Boc-(D)Phe 3 Thioester Strategy H Bts-Val Boc-Sar Boc-(D)Phe4 Thioester Strategy H Bts-Nva Boc-(D)NMeAla Boc-(D)Phe 5 ThioesterStrategy H Bts-Nva Boc-NEtGly Boc-(D)Phe 6 Thioester Strategy H Bts-NvaDdz-Sar Ddz-(D)Trp(Boc) 7 Thioester Strategy H Bts-Nva Ddz-SarDdz-(D)Tyr(But) 8 Thioester Strategy H Bts-Leu Boc-Acp Boc-Phe 9Thioester Strategy H Bts-Val Boc-Acp Boc-Phe 10 Thioester Strategy HBts-Nva Boc-Sar Boc-(D)Phe 11 Thioester Strategy H Bts-Nva Boc-SarBoc-(D)Phe 12 Thioester Strategy H Bts-(D)Val Boc-Nle Boc-Nle 13Thioester Strategy H Bts-(D)Val Boc-Nva Boc-Phe 14 Thioester Strategy HBts-Ile Boc-(D)Ala Boc-Phe 15 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Phe 16 Thioester Strategy H Bts-allo-Ile Boc-(D)NMeAla Boc-(D)Phe17 Thioester Strategy H Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe 18 ThioesterStrategy H Bts-Acp Boc-Acp Boc-Phe 19 Thioester Strategy H Bts-ValBoc-(D)NMeAla Boc-Phe 20 Thioester Strategy H Bts-Leu Boc-AcpBoc-Phe(2-Cl) 21 Thioester Strategy H Bts-Leu Boc-Acp Boc-Phe(3-Cl) 22Thioester Strategy H Bts-Leu Boc-Acp Boc-1Nal 23 Thioester Strategy HBts-Ile Boc-(D)NMeAla Boc-(D)Phe(2-Cl) 24 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Phe(3-Cl) 25 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Phe(4-Cl) 26 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Phe(4-F) 27 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Tyr(OMe) 28 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Bip 29 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Dip 30 Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)1Nal 31Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)2Nal 32 ThioesterStrategy H Bts-Ile Boc-(D)NMeAla Boc-(D)2Pal 33 Thioester Strategy HBts-Ile Boc-(D)NMeAla Boc-(D)4-ThzAla 34 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)2-Thi 35 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Phe 36 Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)Phe 37RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 38 RCM Strategy HFmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 39 Thioester Strategy H Bts-NvaBoc-(D)NMeAla Boc-(D)Phe 40 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Phe 41 Thioester Strategy H Bts-Ile Boc-(D)NMeAbu Boc-(D)Phe 42Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)Phe 43 ThioesterStrategy H Bts-Ile Boc-(D)NEtAla Boc-(D)Phe 44 Thioester Strategy HBts-Leu Boc-Acp Boc-Phe 45 Thioester Strategy H Bts-Leu Ddz-AcpDdz-Glu(OBut) 46 Thioester Strategy H Bts-Leu Boc-Acp Boc-Val 47Thioester Strategy H Bts-Leu Boc-Acp Boc-Leu 48 Thioester Strategy HBts-Leu Boc-Acp Boc-Nva 49 Thioester Strategy H Bts-Nva Boc-SarBoc-(D)Ala 50 Thioester Strategy H Bts-Nva Ddz-Sar Ddz-(D)Glu(OBut) 51Thioester Strategy H Bts-Nva Boc-Sar Boc-Gly 52 Thioester Strategy HBts-Nva Boc-Sar Boc-(D)Nle 53 Thioester Strategy H Bts-Nva Ddz-SarDdz-(D)Orn(Boc) 54 Thioester Strategy H Bts-Nva Ddz-Sar Ddz-(D)Ser(But)55 Thioester Strategy H Bts-(D)Nva Boc-Sar Boc-(D)Phe 56 ThioesterStrategy H Bts-(D)Nva Boc-Sar Boc-Phe 57 Thioester Strategy H Bts-NvaBoc-Sar Boc-Phe 58 Thioester Strategy, Ac Bts-Nva Boc-Sar Boc-(D)Phelinear 59 Thioester Strategy H Bts-Nva Boc-Ala Boc-(D)Phe 60 ThioesterStrategy H Bts-Nva Boc-(D)Ala Boc-(D)Phe 61 Thioester Strategy H Bts-NvaBoc-Gly Boc-(D)Phe 62 Thioester Strategy H Bts-Nva Boc-Leu Boc-(D)Phe 63Thioester Strategy H Bts-Nva Boc-(D)Leu Boc-(D)Phe 64 Thioester StrategyH Bts-Nva Boc-Phe Boc-(D)Phe 65 Thioester Strategy H Bts-Nva Boc-(D)PheBoc-(D)Phe 66 Thioester Strategy H Bts-Nva Boc-Aib Boc-(D)Phe 67Thioester Strategy H Bts-Nva Boc-Acp Boc-(D)Phe 68 Thioester Strategy HBts-Nva Ddz-Lys Boc-(D)Phe 69 Thioester Strategy H Bts-NvaDdz-(D)Lys(Boc) Boc-(D)Phe 70 Thioester Strategy H Bts-Nva Ddz-Glu(OBut)Boc-(D)Phe 71 Thioester Strategy H Bts-Nva Ddz-(D)Glu(OBut) Boc-(D)Phe72 Thioester Strategy H Bts-Ala Boc-Sar Boc-(D)Phe 73 Thioester StrategyH Bts-Glu Boc-Sar Boc-(D)Phe 74 Thioester Strategy H Bts-Lys Boc-SarBoc-(D)Phe 75 Thioester Strategy H Bts-Phe Boc-Sar Boc-(D)Phe 76Thioester Strategy H Bts-Ser Boc-Sar Boc-(D)Phe 77 Thioester Strategy HBts-Nva Boc-Sar Boc-(D)Phe 78 Thioester Strategy H Bts-Nva Boc-SarBoc-(D)Phe 79 Thioester Strategy H Bts-Nva Boc-NMeAla Boc-(D)Phe 80Thioester Strategy H Bts-Gly Boc-Sar Boc-(D)Phe 81 Thioester Strategy HBts-Nva Boc-Sar Boc-(D)Phe 82 Thioester Strategy H Bts-Nva Boc-SarBoc-(D)Phe 83 Thioester Strategy H Bts-Nva Boc-Sar Boc-(D)Phe 84Thioester Strategy H Bts-Nva Boc-Sar Boc-(D)Phe 85 Thioester Strategy HBts-Nva Boc-Sar Boc-(D)Phe 86 Thioester Strategy H Bts-Nva Boc-SarBoc-(D)Phe 87 Thioester Strategy H Bts-Leu Boc-Acp Boc-Ala 88 ThioesterStrategy H Bts-Leu Ddz-Acp Ddz-Tyr(But) 89 Thioester Strategy H Bts-LeuDdz-Acp Ddz-Trp(Boc) 90 Thioester Strategy H Bts-Leu Boc-Acp Boc-Hfe 91Thioester Strategy H Bts-Leu Ddz-Acp Ddz-Lys(Boc) 92 Thioester StrategyH Bts-Leu Ddz-Acp Ddz-Glu(OBut) 93 Thioester Strategy H Bts-Leu Boc-AlaBoc-Phe 94 Thioester Strategy H Bts-Leu Boc-(D)Ala Boc-Phe 95 ThioesterStrategy H Bts-Leu Boc-Aib Boc-Phe 96 Thioester Strategy H Bts-(D)LeuBoc-Acp Boc-Phe 97 Thioester Strategy H Bts-Leu Boc-Acp Boc-(D)Phe 98Thioester Strategy H Bts-(D)Leu Boc-Acp Boc-(D)Phe 99 ThioesterStrategy, Ac Bts-Leu Boc-Acp Boc-Phe linear 100 Thioester Strategy HBts-Ala Boc-Acp Boc-Phe 101 Thioester Strategy H Bts-Nle Boc-Acp Boc-Phe102 Thioester Strategy H Bts-Phe Boc-Acp Boc-Phe 103 Thioester StrategyH Bts-Lys Boc-Acp Boc-Phe 104 Thioester Strategy H Bts-Glu Boc-AcpBoc-Phe 105 Thioester Strategy H Bts-Ser Boc-Acp Boc-Phe 106 ThioesterStrategy H Bts-Leu Boc-Acp Boc-Phe 107 Thioester Strategy H Bts-LeuBoc-Acp Boc-Phe 108 Thioester Strategy H Bts-Leu Boc-Acp Boc-Phe 109Thioester Strategy H Bts-Leu Boc-Acp Boc-Phe 110 Thioester Strategy HBts-Leu Boc-Acp Boc-Gly 111 Thioester Strategy H Bts-Leu Boc-Acc Boc-Phe112 Thioester Strategy H Bts-Gly Boc-Acp Boc-Phe 113 Thioester StrategyH Bts-Leu Boc-Acp Boc-Phe 114 Thioester Strategy H Bts-Leu Boc-AcpBoc-Phe 115 Thioester Strategy H Bts-Leu Boc-Acp Boc-Phe 116 ThioesterStrategy H Bts-Leu Ddz-Acp Ddz-Glu(Et) 117 Thioester Strategy H Bts-AbuBoc-(D)NMeAla Boc-(D)Phe 118 Thioester Strategy H Bts-Leu Boc-(D)NMeAlaBoc-(D)Phe 119 Thioester Strategy H Bts-Thr Boc-(D)NMeAla Boc-(D)Phe 120Thioester Strategy H Bts-Thr(OMe) Boc-(D)NMeAla Boc-(D)Phe 121 ThioesterStrategy H Bts-Acc Boc-(D)NMeAla Boc-(D)Phe 122 Thioester Strategy HBts-Phe(2-Cl) Boc-Acp Boc-Phe 123 Thioester Strategy H Bts-Phe(3-Cl)Boc-Acp Boc-Phe 124 Thioester Strategy H Bts-Phe(4-Cl) Boc-Acp Boc-Phe125 Thioester Strategy H Bts-Phe(4-F) Boc-Acp Boc-Phe 126 ThioesterStrategy H Bts-Hfe Boc-Acp Boc-Phe 127 Thioester Strategy H Bts-Tyr(OMe)Boc-Acp Boc-Phe 128 Thioester Strategy H Bts-Bip Boc-Acp Boc-Phe 129Thioester Strategy H Bts-Dip Boc-Acp Boc-Phe 130 Thioester Strategy HBts-1Nal Boc-Acp Boc-Phe 131 Thioester Strategy H Bts-2Nal Boc-AcpBoc-Phe 132 Thioester Strategy H Bts-3Pal Boc-Acp Boc-Phe 133 ThioesterStrategy H Bts-4Pal Boc-Acp Boc-Phe 134 Thioester Strategy HBts-4-ThzAla Boc-Acp Boc-Phe 135 Thioester Strategy H Bts-2-Thi Boc-AcpBoc-Phe 136 Thioester Strategy H Bts-Abu Boc-Acp Boc-Phe 137 ThioesterStrategy H Bts-Nva Boc-Acp Boc-Phe 138 Thioester Strategy H Bts-IleBoc-Acp Boc-Phe 139 Thioester Strategy H Bts-Val Boc-hcLeu Boc-Phe 140Thioester Strategy H Bts-Val Boc-hc(4O)Leu Boc-Phe 141 ThioesterStrategy H Bts-Val Boc-(4O)Acp Boc-Phe 142 Thioester Strategy H Bts-ValBoc-(3-4)InAcp Boc-Phe 143 Thioester Strategy H Bts-Val Boc-hc(4S)LeuBoc-Phe 144 Thioester Strategy H Bts-Ile Boc-(D)NMeVal Boc-(D)Phe 145Thioester Strategy H Bts-Ile Boc-NMeVal Boc-(D)Phe 146 ThioesterStrategy H Bts-Ile Boc-NMeNva Boc-(D)Phe 147 Thioester Strategy HBts-Ile Boc-(D)NMeLeu Boc-(D)Phe 148 Thioester Strategy H Bts-IleBoc-NMeLeu Boc-(D)Phe 149 Thioester Strategy H Bts-Ile Boc-(D)NMeIleBoc-(D)Phe 150 Thioester Strategy H Bts-Ile Boc-NMeIle Boc-(D)Phe 151Thioester Strategy H Bts-Ile Ddz-(D)Ser(But) Boc-(D)Phe 152 ThioesterStrategy H Bts-Ile Ddz-NMeSer(But) Boc-(D)Phe 153 Thioester Strategy HBts-Leu Boc-Acp Boc-Phe(4-Cl) 154 Thioester Strategy H Bts-Leu Boc-AcpBoc-Phe(4-F) 155 Thioester Strategy H Bts-Leu Boc-Acp Boc-Hfe 156Thioester Strategy H Bts-Leu Boc-Acp Boc-Tyr(OMe) 157 Thioester StrategyH Bts-Leu Boc-Acp Boc-Bip 158 Thioester Strategy H Bts-Leu Boc-AcpBoc-Dip 159 Thioester Strategy H Bts-Leu Boc-Acp Boc-2Nal 160 ThioesterStrategy H Bts-Leu Boc-Acp Boc-2Pal 161 Thioester Strategy H Bts-LeuBoc-Acp Boc-3Pal 162 Thioester Strategy H Bts-Leu Boc-Acp Boc-4Pal 163Thioester Strategy H Bts-Leu Boc-Acp Boc-4-ThzAla 164 Thioester StrategyH Bts-Leu Boc-Acp Boc-2-Thi 165 Thioester Strategy H Bts-Leu Boc-AcpBoc-Abu 166 Thioester Strategy H Bts-Leu Boc-Acp Boc-Ile 167 ThioesterStrategy H Bts-Leu Boc-Acp Boc-allo-Ile 168 Thioester Strategy H Bts-LeuBoc-Acp Boc-Acp 169 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Hfe 170 Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)3Pal171 Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)4Pal 172 ThioesterStrategy H Bts-Ile Boc-(D)NMeAla Boc-Abu 173 Thioester Strategy HBts-Ile Boc-(D)NMeAla Boc-(D)Nva 174 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Val 175 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Ile 176 Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)Leu 177Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)Phe 178 ThioesterStrategy H Bts-Ile Boc-(D)NMeAla Boc-(D)Phe 179 Thioester Strategy HBts-Ile Boc-(D)NMeAla Boc-(D)Phe 180 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Phe 181 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAlaFmoc-(D)Phe 182 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 183RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 184 RCM Strategy HFmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 185 RCM Strategy H Fmoc-IleFmoc-(D)NMeAla Fmoc-(D)Phe 186 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAlaFmoc-(D)Phe 187 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 188RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 189 RCM Strategy HFmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 190 RCM Strategy H Fmoc-IleFmoc-(D)NMeAla Fmoc-(D)Phe 191 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAlaFmoc-(D)Phe 192 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 193RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 194 RCM Strategy HFmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 195 RCM Strategy H Fmoc-IleFmoc-(D)NMeAla Fmoc-(D)Phe 196 Thioester Strategy H Bts-IleBoc-(D)NMeAla Boc-(D)Phe 197 Thioester Strategy H Bts-Ile Boc-(D)NMeAlaBoc-(D)Phe 199 Thioester Strategy H Bts-Val Boc-Acc Boc-Phe 200Thioester Strategy H Bts-Val Boc-Acp Boc-Phe 201 Thioester Strategy MeBts-Nva Boc-(D)NMeAla Boc-(D)Phe 202 Thioester Strategy Ac Bts-NvaBoc-(D)NMeAla Boc-(D)Phe 203 Thioester Strategy Me Bts-Leu Boc-AcpBoc-Phe 204 Thioester Strategy Ac Bts-Leu Boc-Acp Boc-Phe 205 ThioesterStrategy H Bts-Ile Boc-(D)NMeAla Boc-(D)Abu 206 Thioester Strategy HBts-Ile Boc-(D)NMeAla Boc-(D)Phe 207 Thioester Strategy H Bts-ValBoc-hc(4N)Leu Boc-Phe 208 Thioester Strategy H Bts-allo-Ile Boc-AcpBoc-Phe 209 Thioester Strategy H Bts-Ile Boc-(D)NMeAla Boc-(D)allo-Ile210 Thioester Strategy H Bts-2Pal Boc-Acp Boc-Phe 211 Thioester StrategyH Bts-Val Boc-hc(4N)Leu Boc-Phe 212 Thioester Strategy H Bts-IleBoc-NMeAbu Boc-(D)Phe 213 Thioester Strategy H Bts-Ile Boc-(D)4-ThzBoc-(D)Phe 214 RCM Strategy H Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe 215isolated from synthesis of compound 151 216 Thioester Strategy H Bts-ValBoc-Acc Boc-Phe 218 Thioester Strategy H Bts-hcLeu Boc-Acp Boc-Phe 219Acetic Acid H Bts-His(Mts) Boc-Acp Boc-Phe Cyclization 220 ThioesterStrategy H Bts-Nva Boc-Pro Boc-(D)Phe 221 Thioester Strategy H Bts-NvaBoc-(D)Pro Boc-(D)Phe 222 Thioester Strategy H Bts-Leu Boc-Pro Boc-Phe223 Thioester Strategy H Bts-Leu Boc-(D)Pro Boc-Phe 224 RCM Strategy HFmoc-Ile Fmoc-(D)Hyp(But) Fmoc-(D)Phe 225 Thioester Strategy H Bts-ProBoc-(D)NMeAla Boc-(D)Phe 226 Thioester Strategy H Bts-Pip Boc-(D)NMeAlaBoc-(D)Phe Tether Attachment Additional Compound Method TetherReaction** Yield (%)*  1 Mitsunobu Reaction Boc-T9 None 10.1  2Mitsunobu Reaction Boc-T9 None 13.8  3 Mitsunobu Reaction Boc-T9 None10.3  4 Mitsunobu Reaction Boc-T9 None 4.6  5 Mitsunobu Reaction Boc-T9None 8.6  6 Mitsunobu Reaction Ddz-T9 None 8.1  7 Mitsunobu ReactionDdz-T9 None 8.8  8 Mitsunobu Reaction Boc-T8 None 20.9  9 MitsunobuReaction Boc-T9 None 9.7  10  Mitsunobu Reaction Boc-T9 None 9.9  11Mitsunobu Reaction Boc-T8 None 9.9  12 Mitsunobu Reaction Boc-T8 None2.9  13 Mitsunobu Reaction Boc-T8 None 5.8  14 Mitsunobu Reaction Boc-T8None 27.5  15 Mitsunobu Reaction Boc-T9 None 19.5  16 Mitsunobu ReactionBoc-T9 None 23.9  17 Reductive Amination Boc-T9 None 24.8 Reaction  18Mitsunobu Reaction Boc-T8 None 6.8  19 Mitsunobu Reaction Boc-T8 None12.7  20 Mitsunobu Reaction Boc-T8 None 22.0  21 Mitsunobu ReactionBoc-T8 None 24.7  22 Mitsunobu Reaction Boc-T8 None 10.3  23 MitsunobuReaction Boc-T9 None 32.6  24 Mitsunobu Reaction Boc-T9 None 22.4  25Mitsunobu Reaction Boc-T9 None 21.0  26 Mitsunobu Reaction Boc-T9 None15.5  27 Mitsunobu Reaction Boc-T9 None 20.2  28 Mitsunobu ReactionBoc-T9 None 31.6  29 Mitsunobu Reaction Boc-T9 None 26.1  30 MitsunobuReaction Boc-T9 None 31.9  31 Mitsunobu Reaction Boc-T9 None 21.9  32Reductive Amination Boc-T9 None 6.7 Reaction  33 Mitsunobu ReactionBoc-T9 None 7.5  34 Mitsunobu Reaction Boc-T9 None 14.2  35 MitsunobuReaction Boc-T33a None 9.4  36 Mitsunobu Reaction Boc-T33b None 13.0  37Mitsunobu Reaction T_(A1) + T_(B4) None 24.6  38 Mitsunobu ReactionT_(A2) + T_(B1) Hydrogenation 44.2  39 Mitsunobu Reaction Boc-T8 None21.4  40 Mitsunobu Reaction Boc-T8 None 18.6  41 Mitsunobu ReactionBoc-T9 None 10.6  42 Mitsunobu Reaction Boc-T9 None 1.7  43 MitsunobuReaction Boc-T9 None 0.4  44 Mitsunobu Reaction Boc-T1 None 7.8  45Mitsunobu Reaction Ddz-T8 None 11.6  46 Mitsunobu Reaction Boc-T8 None13.6  47 Mitsunobu Reaction Boc-T8 None 9.2  48 Mitsunobu ReactionBoc-T8 None 17.5  49 Reductive Amination Boc-T9 None 7.5 Reaction  50Mitsunobu Reaction Ddz-T9 None 10.1  51 Mitsunobu Reaction Boc-T9 None6.6  52 Mitsunobu Reaction Boc-T9 None 8.7  53 Mitsunobu Reaction Ddz-T9None 8.3  54 Mitsunobu Reaction Ddz-T9 None 6.2  55 Mitsunobu ReactionBoc-T9 None 8.0  56 Mitsunobu Reaction Boc-T9 None 9.3  57 MitsunobuReaction Boc-T9 None 8.9  58 Mitsunobu Reaction Boc-T9 No cyclization5.9  59 Mitsunobu Reaction Boc-T9 None 8.0  60 Mitsunobu Reaction Boc-T9None 13.1  61 Mitsunobu Reaction Boc-T9 None 8.4  62 Mitsunobu ReactionBoc-T9 None 7.0  63 Mitsunobu Reaction Boc-T9 None 11.7  64 MitsunobuReaction Boc-T9 None 8.5  65 Mitsunobu Reaction Boc-T9 None 8.6  66Mitsunobu Reaction Boc-T9 None 15.8  67 Mitsunobu Reaction Boc-T9 None11.7  68 Mitsunobu Reaction Ddz-T9 None 7.9  69 Mitsunobu ReactionDdz-T9 None 11.2  70 Mitsunobu Reaction Ddz-T9 None 10.0  71 MitsunobuReaction Ddz-T9 None 9.9  72 Mitsunobu Reaction Boc-T9 None 5.2  73Mitsunobu Reaction Boc-T9 None 6.8  74 Mitsunobu Reaction Boc-T9 None6.0  75 Mitsunobu Reaction Boc-T9 None 9.5  76 Mitsunobu Reaction Boc-T9None 15.1  77 Mitsunobu Reaction Boc-T12 None 12.6  78 MitsunobuReaction Boc-T27 None 6.8  79 Mitsunobu Reaction Boc-T9 None 1.9  80Mitsunobu Reaction Boc-T9 None 1.3  81 Mitsunobu Reaction Boc-T1 None5.3  82 Mitsunobu Reaction Boc-T3 None 3.9  83 Mitsunobu ReactionBoc-T16 None 1.8  84 Mitsunobu Reaction Boc-T4 None 2.6  85 MitsunobuReaction Boc-T5 None 4.7  86 Mitsunobu Reaction Boc-T14 None 0.4  87Mitsunobu Reaction Boc-T9 None 4.8  88 Mitsunobu Reaction Ddz-T9 None18.8  89 Mitsunobu Reaction Ddz-T9 None 16.5  90 Mitsunobu ReactionBoc-T9 None 8.5  91 Mitsunobu Reaction Ddz-T9 None 6.8  92 MitsunobuReaction Ddz-T9 None 9.1  93 Mitsunobu Reaction Boc-T9 None 9.2  94Mitsunobu Reaction Boc-T9 None 21.8  95 Mitsunobu Reaction Boc-T9 None19.3  96 Mitsunobu Reaction Boc-T9 None 7.0  97 Mitsunobu ReactionBoc-T9 None 9.2  98 Mitsunobu Reaction Boc-T9 None 15.3  99 MitsunobuReaction Boc-T9 No cyclization 10.4 100 Mitsunobu Reaction Boc-T9 None10.4 101 Mitsunobu Reaction Boc-T9 None 19.0 102 Mitsunobu ReactionBoc-T9 None 15.8 103 Mitsunobu Reaction Boc-T9 None 12.9 104 MitsunobuReaction Boc-T9 None 9.3 105 Mitsunobu Reaction Boc-T9 None 11.9 106Mitsunobu Reaction Boc-T3 None 6.3 107 Mitsunobu Reaction Boc-T5 None4.2 108 Mitsunobu Reaction Boc-T12 None 18.3 109 Mitsunobu ReactionBoc-T11 None 10.1 110 Mitsunobu Reaction Boc-T9 None 2.9 111 MitsunobuReaction Boc-T9 None 3.0 112 Mitsunobu Reaction Boc-T9 None 3.2 113Mitsunobu Reaction Boc-T9 None 16.9 114 Mitsunobu Reaction Boc-T16 None2.9 115 Mitsunobu Reaction Boc-T6 None 0.5 116 Mitsunobu Reaction Ddz-T8None 11.8 117 Mitsunobu Reaction Boc-T9 None 19.7 118 Mitsunobu ReactionBoc-T9 None 21.0 119 Mitsunobu Reaction Boc-T9 None 12.2 120 ReductiveAmination Boc-T9 None 17.5 Reaction 121 Mitsunobu Reaction Boc-T9 None5.8 122 Mitsunobu Reaction Boc-T8 None 22.1 123 Mitsunobu ReactionBoc-T8 None 13.6 124 Mitsunobu Reaction Boc-T8 None 9.8 125 MitsunobuReaction Boc-T8 None 15.8 126 Mitsunobu Reaction Boc-T8 None 9.8 127Mitsunobu Reaction Boc-T8 None 14.5 128 Mitsunobu Reaction Boc-T8 None17.8 129 Mitsunobu Reaction Boc-T8 None 11.0 130 Mitsunobu ReactionBoc-T8 None 18.8 131 Mitsunobu Reaction Boc-T8 None 15.0 132 ReductiveAmination Boc-T8 None 17.0 Reaction 133 Reductive Amination Boc-T8 None9.5 Reaction 134 Mitsunobu Reaction Boc-T8 None 12.0 135 MitsunobuReaction Boc-T8 None 4.0 136 Mitsunobu Reaction Boc-T8 None 13.3 137Mitsunobu Reaction Boc-T8 None 19.0 138 Mitsunobu Reaction Boc-T8 None13.8 139 Reductive Amination Boc-T8 None 18.4 Reaction 140 ReductiveAmination Boc-T8 None 16.7 Reaction 141 Reductive Amination Boc-T8 None15.7 Reaction 142 Reductive Amination Boc-T8 None 17.0 Reaction 143Reductive Amination Boc-T8 None 16.1 Reaction 144 Reductive AminationBoc-T9 None 5.7 Reaction 145 Reductive Amination Boc-T9 None 4.9Reaction 146 Reductive Amination Boc-T9 None 23.3 Reaction 147 ReductiveAmination Boc-T9 None 14.4 Reaction 148 Reductive Amination Boc-T9 None25.4 Reaction 149 Reductive Amination Boc-T9 None 11.4 Reaction 150Reductive Amination Boc-T9 None 7.0 Reaction 151 Mitsunobu ReactionDdz-T9 None 8.2 152 Reductive Amination Ddz-T9 None 22.1 Reaction 153Mitsunobu Reaction Boc-T8 None 13.5 154 Mitsunobu Reaction Boc-T8 None14.4 155 Mitsunobu Reaction Boc-T8 None 13.5 156 Mitsunobu ReactionBoc-T8 None 13.2 157 Mitsunobu Reaction Boc-T8 None 20.2 158 MitsunobuReaction Boc-T8 None 11.3 159 Mitsunobu Reaction Boc-T8 None 20.5 160Reductive Amination Boc-T8 None 2.8 Reaction 161 Reductive AminationBoc-T8 None 16.5 Reaction 162 Reductive Amination Boc-T8 None 16.7Reaction 163 Mitsunobu Reaction Boc-T8 None 10.0 164 Mitsunobu ReactionBoc-T8 None 12.5 165 Mitsunobu Reaction Boc-T8 None 13.0 166 MitsunobuReaction Boc-T8 None 11.1 167 Mitsunobu Reaction Boc-T8 None 15.3 168Mitsunobu Reaction Boc-T8 None 4.2 169 Mitsunobu Reaction Boc-T9 None17.0 170 Reductive Amination Boc-T9 None 14.5 Reaction 171 ReductiveAmination Boc-T9 None 16.4 Reaction 172 Mitsunobu Reaction Boc-T9 None12.0 173 Mitsunobu Reaction Boc-T9 None 16.8 174 Mitsunobu ReactionBoc-T9 None 13.9 175 Mitsunobu Reaction Boc-T9 None 15.1 176 MitsunobuReaction Boc-T9 None 9.4 177 Mitsunobu Reaction Boc-T11 None 9.3 178Mitsunobu Reaction Boc-T28 None 11.2 179 Mitsunobu Reaction Boc-T29 None8.6 180 Mitsunobu Reaction Boc-T30 None 10.0 181 Mitsunobu ReactionT_(A1) + T_(B7) None 49.5 182 Mitsunobu Reaction T_(A1) + T_(B7)Hydrogenation 47.7 183 Mitsunobu Reaction T_(A2) + T_(B7) None 59.0 184Mitsunobu Reaction T_(A2) + T_(B7) Hydrogenation 50.6 185 MitsunobuReaction T_(A1) + T_(B6) None 12.4 186 Mitsunobu Reaction T_(A2) +T_(B6) None 3.0 187 Mitsunobu Reaction T_(A1) + T_(B3) None 30.9 188Mitsunobu Reaction T_(A2) + T_(B3) None 34.9 189 Mitsunobu ReactionT_(A2) + T_(B3) Hydrogenation 24.0 190 Mitsunobu Reaction T_(A1) +T_(B4) Hydrogenation 32.5 191 Mitsunobu Reaction T_(A2) + T_(B4) None32.2 192 Mitsunobu Reaction T_(A2) + T_(B4) Hydrogenation 22.2 193Mitsunobu Reaction T_(A1) + T_(B1) None 47.7 194 Mitsunobu ReactionT_(A1) + T_(B1) Hydrogenation 23.7 195 Mitsunobu Reaction T_(A2) +T_(B1) None 66.8 196 Mitsunobu Reaction Ddz-T32(Boc) None 13.0 197Mitsunobu Reaction Ddz-T31(But) None 10.6 199 Reductive Amination Boc-T8None 16.0 Reaction 200 Mitsunobu Reaction Boc-T8 None 14.7 201 ReductiveAmination Boc-T9 Reductive 32.4 Reaction amination reaction withformaldehyde 202 Reductive Amination Boc-T9 Acetylation 14.2 Reaction203 Reductive Amination Boc-T8 Reductive 7.7 Reaction amination reactionwith formaldehyde 204 Reductive Amination Boc-T8 Acetylation 11.5Reaction 205 Mitsunobu Reaction Boc-T9 None 19.9 206 Mitsunobu ReactionBoc-T34 None 26.2 207 Mitsunobu Reaction Boc-T9 None <1 208 MitsunobuReaction Boc-T8 None 16.7 209 Mitsunobu Reaction Boc-T9 None 8.6 210Reductive Amination Boc-T8 None 1.1 Reaction 211 Reductive AminationBoc-T8 None <1 Reaction 212 Mitsunobu Reaction Boc-T9 None 1.2 213Reductive Amination Boc-T9 None 1.0 Reaction 214 Mitsunobu ReactionT_(A1) + T_(B3) Hydrogenation 14.9 215 216 Reductive Amination Boc-T9None 11.6 Reaction 218 Mitsunobu Reaction Boc-T8 None 0.1 219 ReductiveAmination Boc-T8 None 19.0 Reaction 220 Mitsunobu Reaction Boc-T9 None15.0 221 Mitsunobu Reaction Boc-T9 None 14.9 222 Mitsunobu ReactionBoc-T9 None 11.7 223 Mitsunobu Reaction Boc-T9 None 20.4 224 MitsunobuReaction T_(A1) + T_(B2) Hydrogenation 8.2 225 Reductive AminationBoc-T9 None 10.0 Reaction 226 Reductive Amination Boc-T9 None 13.5Reaction *Overall Yield: based on theoretical resin loading, startingfrom ~500 mg resin **Additional reactions conducted post-cyclization,excpet where otherwise noted, to reach the desired product

Table 1B below presents a summary of the synthesis of 122 representativecompounds of the present invention, and Table 1C presents the synthesisof an additional 15 representative compounds. For Table 1B, the reactionmethodology employed for the construction of the macrocyclic molecule isindicated in the Column 2 and relates to the particular scheme of thesynthetic strategy. Columns 3-6 indicate the individual building blocksemployed for each compound, amino acids or tether utilizing eitherstandard nomenclature or referring to the building block designationspresented elsewhere in this application. Column 7 indicates the methodused for attachment of the tether. The building blocks are listed in theopposite order from which they are added in order to correlate thebuilding block number with standard peptide nomenclature. Column 8indicates if any additional reaction chemistry was applied, such as toremove auxiliary protection or to reduce a double bond (as was performedwith many RCM intermediate products). All of the macrocycles in Tables1B and 1C were purified and met the acceptance criteria. Yields (Column9-10) are either isolated or as calculated based upon CLND analysis.

TABLE 1B Synthesis of Representative Compounds of the Present InventionMacrocyclic Compound Assembly Method BB₁ BB₂ BB₃ 298 Thioester StrategyBts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 299 Thioester Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)Phe(4-Cl) 301 Thioester Strategy Bts-Tyr(But)Boc-Acp Boc-Phe(3-Cl) 303 Thioester Strategy Bts-Val Boc-(4O)Acp Boc-Phe305 Thioester Strategy Bts-Ile Boc-(D)NMeAla Boc-(D)His(Mts) 306Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 307 RCMStrategy Fmoc-Cpg Fmoc-(D)NMeAla Fmoc-(D)Phe(4-F) 308 Thioester StrategyBts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-Cl) 309 Thioester Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)Phe(4-F) 310 Thioester Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)3-Thi 311 Thioester Strategy Boc-Cpg Boc-(D)NMeAlaBoc-(D)Tyr(3-tBu) 312 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(2-F) 313 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(3-F) 314 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(2,4-diCl) 315 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(3,4-diCl) 316 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(3,4-diF) 317 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(3,5-diF) 318 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(pentaF) 319 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-Br) 320 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-I) 321 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-CN) 322 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-CF3) 323 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(3,4-diOMe) 324 Thioester Strategy Bts-Cpg Boc-(D)NMcAlaBoc-(D)Trp 325 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-F) 326Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Br) 327 Thioester StrategyBts-Ile Boc-Acp Boc-Phe(3,5-diF) 328 Thioester Strategy Bts-Ile Boc-AcpBoc-Phe(3-OMe) 329 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-CN) 330Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3,4-diCl) 331 ThioesterStrategy Bts-Ile Boc-Acp Boc-Phe(3,4-diF) 332 Thioester Strategy Bts-IleBoc-Acp Boc-Phe(3-CF₃) 333 Thioester Strategy Bts-Ile Boc-Acp Boc-3-Thi334 Thioester Strategy Bts-Acp Boc-Aib Boc-Phe(3-Cl) 335 ThioesterStrategy Boc-Thr(OMe) Boc-(D)NMeAla Boc-(D)Phe(4-F) 336 ThioesterStrategy Bts-Ser(OMe) Boc-(D)NMeAla Boc-(D)Phe(4-F) 337 ThioesterStrategy Boc-Dap(Cbz) Boc-(D)NMeAla Boc-(D)Phe(4-F) 338 ThioesterStrategy Bts-Dab(Boc) Boc-(D)NMeAla Boc-(D)Phe(4-F) 339 ThioesterStrategy Bts-Orn(Boc) Boc-(D)NMeAla Boc-(D)Phe(4-F) 340 ThioesterStrategy Boc-Met Boc-(D)NMeAla Boc-(D)Phe(4-F) 341 Thioester StrategyBts-3-Thi Boc-Acp Boc-Phe(3-Cl) 342 Thioester Strategy Bts-Phe(2-CN)Boc-Acp Boc-Phe(3-Cl) 343 Thioester Strategy Bts-Phe(2-OMe) Boc-AcpBoc-Phe(3-Cl) 344 Thioester Strategy Bts-Ser(OMe) Boc-Acp Boc-Phe(3-Cl)345 Thioester Strategy Bts-Ile Boc-(4O)Acp Boc-Phe(3-Cl) 346 ThioesterStrategy Bts-Cpg Boc-Acp Boc-Phe(3-Cl) 347 Thioester Strategy Bts-IleBoc-Acp Boc-Ser(OBzl) 348 Thioester Strategy Bts-Ile Boc-AcpBoc-Ser(OBzl) 349 Thioester Strategy Bts-Aib Boc-Acp Boc-Phe(3-Cl) 350Thioester Strategy Bts-Aib Boc-Aib Boc-Phe(3-Cl) 351 Thioester StrategyBts-Acp Boc-(D)Ala Boc-Phe(3-Cl) 352 Thioester Strategy Bts-Acp Boc-AlaBoc-Phe(3-Cl) 353 RCM Strategy Fmoc-Ile Fmoc-(D)NMeAla Fmoc-(D)Phe(4-F)354 Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 355Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 356 ThioesterStrategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 357 Thioester StrategyBts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 358 RCM Strategy Fmoc-Ile Fmoc-AcpFmoc-Phe(3-Cl) 359 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 360RCM Strategy Fmoc-Ile Fmoc-Acp Fmoc-Phe(3-Cl) 361 RCM Strategy Fmoc-IleFmoc-Acp Fmoc-Phe(3-Cl) 362 RCM Strategy Fmoc-Ile Fmoc-AcpFmoc-Phe(3-Cl) 363 RCM Strategy Fmoc-Ile Fmoc-Acp Fmoc-Phe(3-Cl) 364 RCMStrategy Fmoc-Ile Fmoc-Acp Fmoc-Phe(3-Cl) 365 RCM Strategy Fmoc-IleFmoc-Acp Fmoc-Phe(3-Cl) 366 RCM Strategy Fmoc-Ile Fmoc-AcpFmoc-Phe(3-Cl) 367 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 368 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 369Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 370 RCM StrategyFmoc-Ile Fmoc-Acp Fmoc-Phe(3-Cl) 371 RCM Strategy Fmoc-Ile Fmoc-AcpFmoc-Phe(3-Cl) 372 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 373 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 374 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 375 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 376 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 377 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 378 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 379 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 380 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 381Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 382 Thioester StrategyBts-Ile Boc-Acp Boc-Phe(3-Cl) 383 Thioester Strategy Bts-Ile Boc-AcpBoc-Phe(3-Cl) 384 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 385Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 386 Thioester StrategyBts-Ile Boc-Acp Boc-Phe(3-Cl) 387 Thioester Strategy Bts-Ile Boc-AcpBoc-Phe(3-Cl) 388 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 389Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 390 ThioesterStrategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 391 Thioester Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)Phe(3,4,5-triF) 392 Thioester Strategy Bts-IleBoc-Acp Boc-Phe(3-Cl) 393 Thioester Strategy Bts-Ile Boc-AcpBoc-Phe(3-Cl) 394 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 395 RCM Strategy Fmoc-Ile Fmoc-(4N)Acp Fmoc-Phe(3-Cl)396 Thioester Strategy Bts-Acp Boc-(D)NMeAla Boc-Phe(3-Cl) 397 ThioesterStrategy Bts-Acp NMeAla Boc-Phe(3-Cl) 398 RCM Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)Phe(4-F) 399 Thioester Strategy Bts-Ile Boc-AcpBoc-Phe(3-Cl) 400 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 401 Thioester Strategy Bts-Cpg Boc-(D)NMeAlaBoc-(D)Phe(4-F) 402 Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) 403Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe 405 ThioesterStrategy Bts-Nva Boc-(D)NMeAla Boc-(D)Phe(4-F) 406 Thioester StrategyBts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-F) 407 Thioester Strategy Bts-IleBoc-(D)NMeAla Boc-(D)Phe(4-F) 408 Thioester Strategy Bts-IleBoc-(D)NMeAla Boc-(D)Phe(4-F) 409 Thioester Strategy Bts-ValBoc-(D)NMeAla Boc-(D)Phe(4-F) 410 RCM Strategy Bts-Nva Boc-(D)NMeAlaBoc-(D)Phe 415 Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-Cl)417 Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-Cl) 430Thioester Strategy Bts-Cpg Boc-(D)NMeAla Boc-(D)Phe(4-Cl) 431 ThioesterStrategy Bts-Ile Boc-(D)NMeAla Boc-(D)Phe 432 Thioesier Strategy Bts-IleBoc-(D)NMeAla Boc-(D)Phe(4-Cl) Tether Additional Amount Yield CompoundTether Attachment Reaction** (mg)* (%)* 298 Boc-T33a Mitsunobu ReactionNone 29.7 12 299 Boc-T9 Mitsunobu Reaction None 54.1 17 301 Ddz-T8Mitsunobu Reaction None 36.5 10 303 Boc-T8 Mitsunobu Reaction None 60 16305 Boc-T9 Reductive Animation None 110 31 Reaction 306 Boc-T11Mitsunobu Reaction None 51 8 307 T_(A2) + T_(B6) Mitsunobu Reaction None13.6 10 308 Boc-T8 Mitsunobu Reaction None 43.8 14 309 Boc-T9 MitsunobuReaction None 38.2 13 310 Boc-T9 Mitsunobu Reaction None 33.3 11 311Boc-T9 Reductive Amination None 18.6 5.1 Reaction 312 Boc-T9 MitsunobuReaction None 42.9 14 313 Boc-T9 Mitsunobu Reaction None 38.2 13 314Boc-T9 Mitsunobu Reaction None 39.7 12 315 Boc-T9 Mitsunobu ReactionNone 35.3 11 316 Boc-T9 Mitsunobu Reaction None 40.7 13 317 Boc-T9Mitsunobu Reaction None 37.6 12 318 Boc-T9 Mitsunobu Reaction None 36.111 319 Boc-T9 Mitsunobu Reaction None 37.5 11 320 Boc-T9 MitsunobuReaction None 43.4 12 321 Boc-T9 Mitsunobu Reaction None 34.5 11 322Boc-T9 Mitsunobu Reaction None 40.8 12 323 Boc-T9 Mitsunobu ReactionNone 27.3 8 324 Boc-T9 Mitsunobu Reaction None 38.6 12 325 Boc-T8Mitsunobu Reaction None 33.7 10 326 Boc-T8 Mitsunobu Reaction None 37.510 327 Boc-T8 Mitsunobu Reaction None 35.2 11 328 Boc-T8 MitsunobuReaction None 31.5 10 329 Boc-T8 Mitsunobu Reaction None 26.9 8 330Boc-T8 Mitsunobu Reaction None 38.4 11 331 Boc-T8 Mitsunobu ReactionNone 37 11 332 Boc-T8 Mitsunobu Reaction None 30.6 9 333 Boc-T8Mitsunobu Reaction None 49.6 18 334 Boc-T8 Mitsunobu Reaction None 32 11335 Boc-T9 Reductive Amination None 62.2 18 Reaction 336 Boc-T9Mitsunobu Reaction None 37.7 12 337 Boc-T9 Reductive AnimationHydrogenolysis 67.5 7 Reaction 338 Boc-T9 Mitsunobu Reaction None 60 20339 Boc-T9 Mitsunobu Reaction None 63 20 340 Boc-T9 Reductive AnimationNone 14.4 4 Reaction 341 Boc-T8 Mitsunobu Reaction None 48 14 342 Boc-T8Mitsunobu Reaction None 37.7 10 343 Boc-T8 Mitsunobu Reaction None 91.325 344 Boc-T8 Mitsunobu Reaction None 22.1 7 345 Boc-T8 MitsunobuReaction None 48 13 346 Boc-T8 Mitsunobu Reaction None 52.1 16 347Boc-T8 Mitsunobu Reaction None 17.1 6 348 Boc-T8 Mitsunobu Reaction None104.4 33 349 Boc-T8 Mitsunobu Reaction None 23.6 7 350 Boc-T8 MitsunobuReaction None 44 15 351 Boc-T8 Mitsunobu Reaction None 39.1 13 352Boc-T8 Mitsunobu Reaction None 15.7 5 353 T_(A1) + T_(B4) MitsunobuReaction None 47.8 25 354 Boc-T65 Mitsunobu Reaction None 26.8 9 355Boc-T70 Mitsunobu Reaction None 36.8 12 356 Boc-T72 Mitsunobu ReactionNone 10 3 357 Ddz-T74(Boc) Mitsunobu Reaction None 41.8 11 358 T_(A1) +T_(B4) Mitsunobu Reaction None 26.1 26 359 Boc-T58 Mitsunobu ReactionNone 43.6 12 360 T_(A2) + T_(B6) Mitsunobu Reaction None 36.3 18 361T_(A2) + T_(B4) Mitsunobu Reaction None 36.3 32 362 T_(A2) + T_(B1)Mitsunobu Reaction Hydrogenation 59.4 57 363 T_(A2) + T_(B7) MitsunobuReaction Hydrogenation 41.8 44 364 T_(A2) + T_(B7) Mitsunobu ReactionHydrogenation 49.1 51 365 T_(A1) + T_(B10) Mitsunobu ReactionHydrogenation 31.2 35 366 T_(A1) + T_(B7) Mitsunobu ReactionHydrogenation 33.3 37 367 Boc-T33b Mitsunobu Reaction None 21.1 6 368Boc-T33a Mitsunobu Reaction None 21.8 10 369 Boc-T9 Mitsunobu ReactionNone 21.1 4 370 T_(A2) + T_(B6) Mitsunobu Reaction Hydrogenation 8.9 NA371 T_(A2) + T_(B4) Mitsunobu Reaction Hydrogenation 9.9 NA 372 Boc-T69Mitsunobu Reaction None 30.9 10 373 Boc-T71 Mitsunobu Reaction None 34.911 374 Ddz-T73(Boc) Mitsumobu Reaction None 42.7 12 375 Boc-T39Mitsunobu Reaction None 22.3 7 376 Boc-T40 Mitsunobu Reaction None 7.5 2377 Boc-T10 Mitsunobu Reaction None 14.6 5 378 Boc-T58 MitsunobuReaction None 65.3 21 379 Boc-T67 Mitsunobu Reaction None 36.3 12 380Boc-T66 Mitsunobu Reaction None 16.5 5 381 Boc-T65 Mitsunobu ReactionNone 22.5 7 382 Boc-T70 Mitsunobu Reaction None 24.5 7 383 Boc-T69Mitsunobu Reaction None 25.2 7 384 Boc-T71 Mitsunobu Reaction None 21.96 385 Boc-T11 Mitsunobu Reaction None 23.3 7 386 Boc-T39 MitsunobuReaction None 12 4 387 Boc-T68 Mitsunobu Reaction None 17.1 5 388Boc-T67 Mitsunobu Reaction None 30 9 389 Boc-T68 Mitsunobu Reaction None16.1 5 390 Boc-T18 Mitsunobu Reaction None 28.7 10 391 Boc-T9 MitsunobuReaction None 45.4 14 392 Boc-T40 Mitsunobu Reaction None 4.3 1 393Boc-T45 Mitsunobu Reaction None 2.1 1 394 Boc-T38 Mitsunobu ReactionNone 3.7 1 395 T_(A1) + T_(B2) Mitsunobu Reaction Hydrogenation 0.2 0.2396 Boc-T8 Mitsunobu Reaction None 2.3 1 397 Boc-T8 Mitsunobu ReactionNone 1.4 0.4 398 T_(A2) + T_(B6) Mitsunobu Reaction Hydrogenation 3.8 1399 Boc-T33b Mitsunobu Reaction None 5.7 4 400 Boc-T66 MitsunobuReaction None 28.3 9 401 Boc-T8 Mitsunobu Reaction None 31.5 11 402Boc-T8 Mitsunobu Reaction None 29.1 9 403 Boc-T33a Mitsunobu ReactionNone 103 11 405 Boc-T33a Mitsunobu Reaction None 38.8 12 406 Boc-T75aMitsunobu Reaction None 45 13 407 Boc-T33a Mitsunobu Reaction None 138.516 408 Boc-T75a Mitsunobu Reaction None 146.2 21 409 Boc-T33a MitsunobuReaction None 125.7 19 410 Boc-T75a Mitsunobu Reaction None 36 11 415Boc-T33a Mitsunobu Reaction None 127.5 12 417 Boc-T69 Mitsunobu ReactionNone 45.6 13 430 Boc-T75a Mitsunobu Reaction None 50.7 14 431 Boc-T33aMitsunobu Reaction None 57.9 17 432 Boc-T33a Mitsunobu Reaction None 14113 *Overall Yield: based on theoretical resin loading, starting from~500 mg resin **Additional reactions conducted post-cyclization to reachthe desired product

TABLE 1C Synthesis of Representative Compounds of the Present InventionMacrocyclic Compound Assembly Method BB₁ BB₂ BB₃ 435 Thioester StrategyBts-Cpg Boc-(D)NMeAla Boc-(D)Phe 436 Thioester Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)Phe 437 Thioester Strategy Bts-Acp Boc-AcpBoc-Phe(3-Cl) 438 Thioester Strategy Bts-Leu Boc-Acp Boc-Phe(3-Cl) 439Thioester Strategy Bts-Ile Boc-(3/4O)Acp Boc-Phe(3-Cl) 440 RCM StrategyBts-Ile Fmoc-(D)NMeSer(OBzl) Fmoc-(D)Phe(4-F) 441 Thioester StrategyBts-Ile Ddz-Acp Ddz-Phe(4-CO₂tBu) 442 Thioester Strategy Bts-Ile Ddz-AcpDdz-Ser(But) 443 Thioester Strategy Bts-Ile Boc-Acp Boc-Ser(OMe) 444Thioester Strategy Boc-Leu Boc-Acp Boc-His(Mts) 445 Thioester StrategyBts-Ile Ddz-(D)NMeAla Ddz-(D)Tyr(But) 446 Thioester Strategy Bts-CpgBoc-(D)NMeAla Boc-(D)Phe(4-F) 447 RCM Strategy Bts-Ile Fmoc-AcpFmoc-Phe(3-Cl) 448 RCM Strategy Bts-Nva Fmoc-Sar Fmoc-(DL)αMePhe 449Thioester Strategy Bts-Ile Boc-Acp Boc-Phe(3-Cl) Tether AdditionalAmount Yield Compound Tether Attachment Reaction** (mg) (%) 435 Boc-T75aMitsunobu Reaction None 29.7 9 436 Boc-T76 Mitsunobu Reaction None 37.811 437 Boc-T8 Mitsunobu Reaction None 8.3 2 438 Boc-T33a MitsunobuReaction None 51.2 5 439 Boc-T8 Mitsunobu Reaction None 5.9 2 440T_(A1) + T_(B2) Mitsunobu Reaction Hydrogenation 2.7 2 441 Ddz-T8Mitsunobu Reaction None 9.8 3 442 Ddz-T8 Mitsunobu Reaction None 17.1 6443 Boc-T8 Mitsunobu Reaction None 19 7 444 Boc-T8 Reductive AnimationNone 21 7 Reaction 445 Boc-T9 Mitsunobu Reaction None 15.5 5 446 Boc-T45Mitsunobu Reaction None 3.2 1 447 T_(A1) + T_(B9) Mitsunobu ReactionHydrogenation 18.2 21 448 T_(A1) + T_(B2) Mitsunobu ReactionHydrogenation 4.8 2 449 Boc-T77 Mitsunobu Reaction None 2.6 1 *OverallYield: based on theoretical resin loading, starting from ~500 mg resin**Additional reactions conducted post-cyclization to obtain the desiredproductThe tables directly below present analytical data obtained for compounds1-197, 199-216, 218-230 (Table 2A), compounds 298, 299, 301, 303,304-403, 405-410, 415, 417 and 430-432 (Table 2B) and compounds 435-449(Table 2C), as determined by LC-MS analysis of the purified products.These compounds were further examined for their ability to interact atthe human ghrelin receptor utilizing the biological test methodsdescribed below.

TABLE 2A Analytical Characterization for Representative Compounds of thePresent Invention MW Compound Molecular Formula Calc (g/mol) MS [(M +H)+] Found 1 C29H40N4O4 508.7 509 2 C29H40N4O4 508.7 509 3 C28H38N4O4494.6 495 4 C29H40N4O4 508.7 509 5 C29H40N4O4 508.7 509 6 C30H39N5O4533.7 534 7 C28H38N4O5 510.6 511 8 C32H42N4O4 546.7 547 9 C31H42N4O4534.7 535 10 C28H38N4O4 494.6 495 11 C28H36N4O4 492.6 493 12 C28H45N4O4501.7 502 13 C30H40N4O4 520.7 521 14 C29H38N4O4 506.6 507 15 C30H42N4O4522.7 523 16 C30H42N4O4 522.7 523 17 C29H38N4O4 506.6 507 18 C32H40N4O4544.7 545 19 C29H38N4O4 506.6 507 20 C32H41N4O4Cl 581.1 581 21C32H41N4O4Cl 581.1 581 22 C36H44N4O4 596.8 597 23 C30H41N4O4Cl 557.1 55724 C30H41N4O4Cl 557.1 557 25 C30H41N4O4Cl 557.1 557 26 C30H41N4O4F 540.7541 27 C31H44N4O5 552.7 553 28 C36H46N4O4 598.8 599 29 C36H46N4O4 598.8599 30 C34H44N4O4 572.7 573 31 C34H44N4O4 572.7 573 32 C29H41N5O4 523.7524 33 C27H39N5O4S 529.7 530 34 C28H40N4O4S 528.7 529 35 C31H44N4O4536.7 537 36 C31H44N4O4 536.7 537 37 C31H42N4O3 518.7 519 38 C31H44N4O3520.7 521 39 C29H38N4O4 506.6 507 40 C30H40N4O4 520.7 521 41 C31H44N4O4536.7 537 42 C30H42N4O4 522.7 523 43 C31H44N4O4 536.7 537 44 C25H38N4O4458.6 459 45 C28H40N4O6 528.6 529 46 C28H42N4O4 498.7 499 47 C29H44N4O4512.7 513 48 C28H42N4O4 498.7 499 49 C22H34N4O4 418.5 419 50 C24H36N4O6476.6 477 51 C21H32N4O4 404.5 405 52 C25H40N4O4 460.6 461 53 C24H39N5O4461.6 462 54 C22H34N4O5 434.5 435 55 C28H38N4O4 494.6 495 56 C28H38N4O4494.6 495 57 C28H38N4O4 494.6 495 58 C30H43N5O5 553.7 554 59 C28H38N4O4494.6 495 60 C28H38N4O4 494.6 495 61 C27H36N4O4 480.6 481 62 C31H44N4O4536.7 537 63 C31H44N4O4 536.7 537 64 C34H42N4O4 570.7 571 65 C34H42N4O4570.7 571 66 C29H40N4O4 508.7 509 67 C31H42N4O4 534.7 535 68 C31H45N5O4551.7 552 69 C31H45N5O4 551.7 552 70 C30H40N4O6 552.7 553 71 C30H40N4O6552.7 553 72 C26H34N4O4 466.6 467 73 C28H36N4O6 524.6 525 74 C29H41N5O4523.7 524 75 C32H38N4O4 542.7 543 76 C26H34N4O5 482.6 483 77 C31H36N4O3S544.7 545 78 C23H34N4O4 430.5 431 79 C29H41N4O4 509.7 510 80 C25H33N4O4453.6 454 81 C21H33N4O4 405.5 406 82 C23H33N4O3 413.5 414 83 C23H35N4O3415.5 416 84 C25H33N4O3 437.6 438 85 C26H35N4O3 451.6 452 86 C22H30N5O3S444.6 445 87 C26H40N4O4 472.6 473 88 C32H44N4O5 564.7 565 89 C34H45N5O4587.8 588 90 C33H46N4O4 562.7 563 91 C29H47N5O4 529.7 530 92 C28H42N4O6530.7 531 93 C29H40N4O4 508.7 509 94 C29H40N4O4 508.7 509 95 C30H42N4O4522.7 523 96 C32H44N4O4 548.7 549 97 C32H44N4O4 548.7 549 98 C32H44N4O4548.7 549 99 C34H49N5O5 607.8 608 100 C29H38N4O4 506.6 507 101C32H44N4O4 548.7 549 102 C35H42N4O4 582.7 583 103 C32H45N5O4 563.7 564104 C31H40N4O6 564.7 565 105 C29H38N4O5 522.6 523 106 C27H38N4O3 466.6467 107 C30H40N4O3 504.7 505 108 C35H42N4O3S 598.8 599 109 C31H43N5O4549.7 550 110 C25H39N4O4 459.6 460 111 C30H40N4O4 520.7 521 112C28H37N4O4 493.6 494 113 C32H45N4O4 549.7 550 114 C27H41N4O3 469.6 470115 C30H41N4O3 505.7 506 116 C30H44N4O6 556.7 557 117 C28H38N4O4 494.6495 118 C30H42N4O4 522.7 523 119 C28H38N4O5 510.6 511 120 C29H40N4O5524.7 525 121 C28H36N4O4 492.6 493 122 C35H39N4O4Cl 615.2 615 123C35H39N4O4Cl 615.2 615 124 C35H39N4O4Cl 615.2 615 125 C35H39N4O4F 598.7599 126 C36H42N4O4 594.7 595 127 C36H42N4O5 610.7 611 128 C41H44N4O4656.8 657 129 C41H44N4O4 656.8 657 130 C39H42N4O4 630.8 631 131C39H42N4O4 630.8 631 132 C34H39N5O4 581.7 582 133 C34H39N5O4 581.7 582134 C32H37N5O4S 587.7 588 135 C33H38N4O4S 586.7 587 136 C30H38N4O4 518.6519 137 C31H40N4O4 532.7 533 138 C32H42N4O4 546.7 547 139 C32H42N4O4546.7 547 140 C31H40N4O5 548.7 549 141 C30H38N4O5 534.6 535 142C35H40N4O4 580.7 581 143 C31H40N4O4S 564.7 565 144 C32H46N4O4 550.7 551145 C32H46N4O4 550.7 551 146 C32H46N4O4 550.7 551 147 C33H48N4O4 564.8565 148 C33H48N4O4 564.8 565 149 C33H48N4O4 564.8 565 150 C33H48N4O4564.8 565 151 C29H40N4O5 524.7 525 152 C30H42N4O5 538.7 539 153C32H41N4O4Cl 581.1 581 154 C32H41N4O4F 564.7 565 155 C33H44N4O4 560.7561 156 C33H44N4O5 576.7 577 157 C38H46N4O4 622.8 623 158 C38H46N4O4622.8 623 159 C36H44N4O4 596.8 597 160 C31H41N5O4 547.7 548 161C31H41N5O4 547.7 548 162 C31H41N5O4 547.7 548 163 C29H39N5O4S 553.7 554164 C30H40N4O4S 552.7 553 165 C27H40N4O4 484.6 485 166 C29H44N4O4 512.7513 167 C29H44N4O4 1.0 2 168 C29H42N4O4 510.7 511 169 C31H44N4O4 536.7537 170 C29H41N5O4 523.7 524 171 C29H41N5O4 523.7 524 172 C25H40N4O4460.6 461 173 C26H42N4O4 474.6 475 174 C26H42N4O4 474.6 475 175C27H44N4O4 488.7 489 176 C27H44N4O4 488.7 489 177 C29H41N5O4 523.7 524178 C29H40N4O4 508.7 509 179 C30H42N4O3 506.7 507 180 C31H44N4O3 520.7521 181 C26H40N4O3 456.6 457 182 C26H42N4O3 458.6 459 183 C27H42N4O3470.6 471 184 C27H44N4O3 472.7 473 185 C25H38N4O4 458.6 459 186C26H40N4O4 472.6 473 187 C30H40N4O3 504.7 505 188 C31H42N4O3 518.7 519189 C31H44N4O3 520.7 521 190 C31H44N4O3 520.7 521 191 C32H44N4O3 532.7533 192 C32H46N4O3 534.7 535 193 C30H40N4O3 504.7 505 194 C30H42N4O3506.7 507 195 C31H42N4O3 518.7 519 196 C31H44N6O4 564.7 565 197C31H42N4O6 566.7 567 199 C29H36N4O4 504.6 505 200 C31H40N4O4 532.7 533201 C30H42N4O4 522.7 523 202 C31H42N4O5 550.7 551 203 C33H44N4O4 560.7561 204 C34H44N4O5 588.7 589 205 C25H40N4O4 460.6 461 206 C31H46N6O5582.7 583 207 C31H43N5O4 549.7 550 208 C32H42N4O4 546.7 547 209C27H44N4O4 488.7 489 210 C34H39N5O4 581.7 582 211 C31H41N5O4 547.7 548212 C31H44N4O4 536.7 537 213 C30H40N4O4S 552.7 553 214 C30H42N4O3 506.7507 215 C33H48N4O5 580.8 581 216 C29H38N4O4 506.6 507 218 C33H42N4O4558.7 559 219 C32H38N6O4 570.7 571 220 C30H40N4O4 520.7 521 221C30H40N4O4 520.7 521 222 C31H42N4O4 534.7 535 223 C31H42N4O4 534.7 535224 C31H42N4O5 550.7 551 225 C29H38N4O4 506.6 507 226 C30H40N4O4 520.7521 227 C30H40N4O4 520.7 521 228 C30H40N4O4 520.7 521 229 C31H42N4O4534.7 535 230 C31H42N4O4 534.7 535 Notes 1. Molecular formulas andmolecular weights are calculated automatically from the structure viaActivityBase software (IDBS, Guildford, Surrey, UK). 2. M + H obtainedfrom LC-MS analysis using standard methods. 3. All analyses conducted onmaterial after preparative purification by the methods described above.

TABLE 2B Analytical Characterization for Representative Compounds of thePresent Invention MW Compound Molecular Formula Calc (g/mol) MS [(M +H)⁺] Found 298 C30H39N4O4F 538.7 539 299 C29H37N4O4Cl 541.1 541 301C35H39N4O5Cl 631.2 631 303 C30H38N4O5 534.6 535 305 C27H40N6O4 512.6 513306 C28H36N5O4F 525.6 526 307 C25H35N4O4F 474.6 475 308 C29H35N4O4Cl539.1 539 309 C29H37N4O4F 524.6 525 310 C27H36N4O4S 512.7 513 311C33H46N4O5 578.7 579 312 C29H37N4O4F 524.6 525 313 C29H37N4O4F 524.6 525314 C29H36N4O4Cl2 575.5 575 315 C29H36N4O4Cl2 575.5 575 316 C29H36N4O4F2542.6 543 317 C29H36N4O4F2 542.6 543 318 C29H33N4O4F5 596.6 597 319C29H37N4O4Br 585.5 585 320 C29H37N4O4I 632.5 633 321 C30H37N5O4 531.6532 322 C30H37N4O4F3 574.6 575 323 C31H42N4O6 566.7 567 324 C31H39N5O4545.7 546 325 C32H41N4O4F 564.7 565 326 C32H41N4O4Br 625.6 625 327C32H40N4O4F2 582.7 583 328 C33H44N4O5 576.7 577 329 C33H41N5O4 571.7 572330 C32H40N4O4Cl2 615.6 616 331 C32H40N4O4F2 582.7 583 332 C33H41N4O4F3614.7 615 333 C30H40N4O4S 552.7 553 334 C30H37N4O4Cl 553.1 553 335C29H39N4O5F 542.6 543 336 C28H37N4O5F 528.6 529 337 C27H36N5O4F 513.6514 338 C28H38N5O4F 527.6 528 339 C29H40N5O4F 541.7 542 340 C29H39N4O4FS558.7 559 341 C33H37N4O4SCl 621.2 621 342 C36H38N5O4Cl 640.2 640 343C36H41N4O5Cl 645.2 645 344 C30H37N4O5Cl 569.1 569 345 C31H39N4O5Cl 583.1583 346 C31H37N4O4Cl 565.1 565 347 C33H44N4O5 576.7 577 348 C31H42N4O5550.7 551 349 C30H37N4O4Cl 553.1 553 350 C28H35N4O4Cl 527.1 527 351C29H35N4O4Cl 539.1 539 352 C29H35N4O4Cl 539.1 539 353 C31H41N4O3F 536.7537 354 C29H33N4O4F 520.6 521 355 C29H36N4O4F2 542.6 543 356C30H36N4O4F4 592.6 593 357 C30H40N5O6FS 617.7 618 358 C33H43N4O3Cl 579.2579 359 C34H47N4O4Cl 611.2 611 360 C28H41N4O4Cl 533.1 533 361C34H45N4O3Cl 593.2 593 362 C33H45N4O3Cl 581.2 581 363 C29H45N4O3Cl 533.1533 364 C29H43N4O3Cl 531.1 531 365 C27H41N4O3Cl 505.1 505 366C28H43N4O3Cl 519.1 519 367 C30H39N4O4F 538.7 539 368 C33H45N4O4Cl 597.2597 369 C32H43N4O4Cl 583.2 583 370 C28H43N4O4Cl 535.1 535 371C34H47N4O3Cl 595.2 595 372 C29H36N4O4F2 542.6 543 373 C29H36N4O4FCl559.1 559 374 C30H40N5O6FS 617.7 618 375 C30H39N4O4F 538.7 539 376C30H39N4O4F 538.7 539 377 C28H35N4O5F 526.6 527 378 C31H41N4O4F 552.7553 379 C30H37N4O4F 536.6 537 380 C32H41N4O4Cl 581.1 581 381C32H39N4O4Cl 579.1 579 382 C32H42N4O4FCl 601.2 601 383 C32H42N4O4FCl601.2 601 384 C32H42N4O4Cl2 617.6 617 385 C31H42N5O4Cl 584.1 584 386C33H45N4O4Cl 597.2 597 387 C33H43N4O4Cl 595.2 595 388 C33H43N4O4Cl 595.2595 389 C30H37N4O4F 536.6 537 390 C26H40N5O3Cl 506.1 506 391C29H35N4O4F3 560.6 561 392 C33H45N4O4Cl 597.2 597 393 C27H41N4O5Cl 537.1537 394 C30H39N4O4F 538.7 539 395 C31H42N5O4Cl 584.1 584 396C30H37N4O4Cl 553.1 553 397 C30H37N4O4Cl 553.1 553 398 C25H37N4O4F 476.6477 399 C33H45N4O4Cl 597.2 597 400 C29H35N4O4F 522.6 523 401 C29H35N4O4F522.6 523 402 C32H41N4O4Cl 581.1 581 403 C30H40N4O4 520.7 521 405C30H41N4O4F 540.7 541 406 C30H38N4O4F2 556.6 557 407 C31H43N4O4F 554.7555 408 C31H42N4O4F2 572.7 573 409 C30H41N4O4F 540.7 541 410 C30H42N4O4522.7 523 415 C30H39N4O4Cl 555.1 555 417 C29H36N4O4FCl 559.1 559 430C30H38N4O4FCl 573.1 573 431 C31H44N4O4 536.7 537 432 C31H43N4O4Cl 571.2571 Notes 1. Molecular formulas and molecular weights are calculatedautomatically from the structure via ActivityBase software (IDBS,Guildford, Surrey, UK). 2. M + H obtained from LC-MS analysis usingstandard methods. 3. All analyses conducted on material afterpreparative purification by the methods described above.

TABLE 2C Analytical Characterization for Representative Compounds of thePresent Invention MW Compound Molecular Formula Calc (g/mol) MS [(M +H)⁺] Found 435 C30H39N4O4F 538.7 539 436 C31H40N4O4 532.7 533 437C32H39N4O4Cl 579.1 579 438 C33H45N4O4Cl 597.2 597 439 C32H39N4O5Cl 595.1595 440 C37H47N4O5F 646.8 647 441 C33H42N4O6 590.7 591 442 C26H38N4O5486.6 487 443 C27H40N4O5 500.6 501 444 C29H40N6O4 536.7 537 445C30H42N4O5 538.7 539 446 C24H35N4O5F 478.6 479 447 C26H39N4O3Cl 491.1492 448 C29H40N4O4 508.7 509 449 C31H42N5O4Cl 584.1 584 Notes 1.Molecular formulas and molecular weights are calculated automaticallyfrom the structure via ActivityBase software (IDBS, Guildford, Surrey,UK). 2. M + H obtained from LC-MS analysis using standard methods. 3.All analyses conducted on material after preparative purification by themethods described above.D. Chiral Purity Determination

General methods for the HPLC determination of stereoisomeric purity wereemployed according to techniques known to those skilled in the art andfurther optimized for the compounds of the present invention.

Method Chiral A: Grad35A-05 (Column: Chiralcel AS-RH, 0.46 cm×15 cm):

-   1. Isocratic plateau of 40 min at 35% ACN, 65% of a 50 mM solution    of CH₃COONH₄ in H₂O.-   2. 5 min gradient to 70% ACN, 30% of a 50 mM solution of CH₃COONH₄    in H₂O.-   3. Isocratic plateau of 10 min at 70% ACN, 30% of a 50 mM solution    of CH3COONH₄ in H₂O.-   4. 5 min gradient to 35% ACN, 65% of a 50 mM solution of CH₃COONH₄    in H₂O.-   5. Isocratic plateau of 10 min at 35% ACN, 65% of a 50 mM solution    of CH₃COONH₄ in H₂O.-   6. Flow: 0.5 mL/min-   7. Column temperature: room temperature-   8. Sample temperature: room temperature    Method Chiral B: Grad40A-05 (Column: Chiralcel OD-RH, 0.46 cm×15    cm):-   1. Isocratic plateau of 40 min at 40% ACN, 60% of a solution 50 mM    of CH₃COONH₄ in H₂O.-   2. 5 min gradient to 70% ACN, 30% of a solution 50 mM of CH₃COONH₄    in H₂O.-   3. Isocratic plateau of 10 min at 70% ACN, 30% of a solution 50 mM    of CH₃COONH₄ in H₂O.-   4. 5 min gradient to 40% ACN, 60% of a solution 50 mM of CH₃COONH₄    in H₂O.-   5. Isocratic plateau of 10 min at 40% ACN, 60% of a solution 50 mM    of CH₃COONH₄ in H₂O.-   6. Flow: 0.5 mL/min-   7. Column temperature: room temperature-   8. Sample temperature: room temperature    Method Chiral C: Grad 55A-05 (Column: Chiralcel OD-RH, 0.46 cm×15    cm):-   1. 40 min isocratic 55%/45% of ACN/50 mM CH₃COONH₄ in H₂O-   2. 5 min gradient to 70%/30% of ACN/50 mM CH₃COONH₄ in H₂O-   3. 10 min isocratic 70%/30% of ACN/50 mM CH₃COONH₄ in H₂O-   4. 5 min gradient to 55%/44% of ACN/50 mM CH₃COONH₄ in H₂O-   5. 10 min isocratic 55%/45% of ACN/50 mM CH₃COONH₄ in H₂O-   6. Flow: 0.5 mL/min-   7. Column temperature: room temperature-   8. Sample temperature: room temperature    Method Chiral D: Grad Iso100B_(—)05 (Column: Chiralcel OD-RH, 0.46    cm×15 cm)-   1. 40 min isocratic 27%/73% of ACN/50 mM CH₃COONH₄ in H₂O-   2. 5 min gradient to 70%/30% of ACN/50 mM CH₃COONH₄ in H₂O-   3. 10 min isocratic 70%/30% of ACN/50 mM CH₃COONH₄ in H₂O-   4. 5 min gradient to 27%/73% of ACN/50 mM CH₃COONH₄ in H₂O-   5. 10 min isocratic 27%/73% of ACN/50 mM CH₃COO in H₂O-   6. Flow: 0.5 mL/min-   7. Column temperature: room temperature-   8. Sample temperature: room temperature    3. Biological Methods

The compounds of the present invention were evaluated for their abilityto interact at the human ghrelin receptor utilizing a competitiveradioligand binding assay, fluorescence assay or Aequorin functionalassay as described below. Such methods can be conducted in a highthroughput manner to permit the simultaneous evaluation of manycompounds.

Specific assay methods for the human (GHS-R1a), swine and ratGHS-receptors (U.S. Pat. No. 6,242,199, Intl. Pat. Appl. Nos. WO97/21730 and 97/22004), as well as the canine GHS-receptor (U.S. Pat.No. 6,645,726), and their use in generally identifying agonists andantagonists thereof are known.

Appropriate methods for determining the functional activity of compoundsof the present invention that interact at the human ghrelin receptor arealso described below.

A. Competitive Radioligand Binding Assay (Ghrelin Receptor)

The competitive binding assay at the human growth hormone secretagoguereceptor (hGHS-R1a) was carried out analogously to assays described inthe literature. (Bednarek M A et al. Structure-function studies on thenew growth hormone-releasing peptide ghrelin: minimal sequence ofghrelin necessary for activation of growth hormone secretagogue receptor1a; J. Med. Chem. 2000, 43, 4370-4376; Palucki, B. L. et al.Spiro(indoline-3,4′-piperidine) growth hormone secretagogues as ghrelinmimetics; Bioorg. Med. Chem. Lett. 2002, 11, 1955-1957.)

Materials

Membranes (GHS-R/HEK 293) were prepared from HEK-293 cells stablytransfected with the human ghrelin receptor (hGHS-R1a). These membraneswere provided by PerkinElmer BioSignal (#RBHGHSM, lot#1887) and utilizedat a quantity of 0.71 μg/assay point.

-   1. [¹²⁵I]-Ghrelin (PerkinElmer, #NEX-388); final concentration:    0.0070-0.0085 mM-   2. Ghrelin (Bachem, #H-4864); final concentration: 1 μM-   3. Multiscreen Harvest plates-GF/C (Millipore, #MAHFC1H60)-   4. Deep-well polypropylene titer plate (Beckman Coulter, #267006)-   5. TopSeal-A (PerkinElmer, #6005185)-   6. Bottom seal (Millipore, #MATAH0P00)-   7. MicroScint-0 (PerkinElmer, #6013611)-   8. Binding Buffer: 25 mM Hepes (pH 7.4), 1 mM CaCl₂, 5 mM MgCl₂, 2.5    mM EDTA, 0.4% BSA    Assay Volumes

Competition experiments were performed in a 300 μl filtration assayformat.

-   1. 220 μL of membranes diluted in binding buffer-   2. 40 μL of compound diluted in binding buffer-   3. 40 μL of radioligand ([¹²⁵I]-Ghrelin) diluted in binding buffer    Final test concentrations (N=1) for compounds of the present    invention:    10, 1, 0.5, 0.2, 0.1, 0.05, 0.02, 0.01, 0.005, 0.002, 0.001 μM.    Compound Handling

Compounds were provided frozen on dry ice at a stock concentration of 10mM diluted in 100% DMSO and stored at −80° C. until the day of testing.On the test day, compounds were allowed to thaw at rt O/N and thendiluted in assay buffer according to the desired test concentrations.Under these conditions, the maximal final DMSO concentration in theassay was 0.1%.

Assay Protocol

In deep-well plates, 220 μL of diluted cell membranes (finalconcentration: 0.71 μg/well) were combined with 40 μL of either bindingbuffer (total binding, N=5), 1 μM ghrelin (non-specific binding, N=3) orthe appropriate concentration of test compound (N=2 for each testconcentration). The reaction was initiated by addition of 40 μL of[¹²⁵I]-ghrelin (final conc. 0.0070-0.0085 nM) to each well. Plates weresealed with TopSeal-A, vortexed gently and incubated at rt for 30 min.The reaction was arrested by filtering samples through MultiscreenHarvest plates (pre-soaked in 0.5% polyethyleneimine) using a TomtecHarvester, washed 9 times with 500 μL of cold 50 mM Tris-HCl (pH 7.4, 4°C.), and then plates were air-dried in a fumehood for 30 min. A bottomseal was applied to the plates prior to the addition of 25 μL ofMicroScint-0 to each well. Plates were than sealed with TopSeal-A andcounted for 30 sec per well on a TopCount Microplate Scintillation andLuminescence Counter (PerkinElmer) using a count delay of 60 sec.Results were expressed as counts per minute (cpm).

Data were analyzed by GraphPad Prism (GraphPad Software, San Diego,Calif.) using a variable slope non-linear regression analysis. K_(i)values were calculated using a K_(d) value of 0.01 nM for [¹²⁵I]-ghrelin(previously determined during membrane characterization).

D_(max) values were calculated using the following formula:

$D_{\max} = {1 - {\frac{\begin{matrix}{{test}\mspace{14mu}{concentration}\mspace{14mu}{with}} \\\begin{matrix}{{{maximal}\mspace{14mu}{displacement}} -} \\{{non}\text{-}{specific}\mspace{14mu}{binding}}\end{matrix}\end{matrix}}{{{total}\mspace{14mu}{binding}} - {{non}\text{-}{specific}\mspace{14mu}{binding}}} \times 100}}$where total and non-specific binding represent the cpm obtained in theabsence or presence of 1 μM ghrelin, respectively.

Binding activity at the gherlin receptor for representative compounds ofthe present invention is shown below in Table 3A through 3D. Compoundstructures for Tables 3A, 3B and 3D are presented with the variousgroups as defined for the general structure of formula I. For Tables 3Band 3D, in all entries, m, n and p are 0; X, Z₁ and Z₂ are each NH. ForTable 3B, R₁ is H for all entries. The tethers (T) are illustrated withthe bonding to X and Z₂ as indicated. The compounds themselves are shownfor Table 3C. Competitive binding curves for representative compounds 1,2, 3, 4 and 25 are shown in FIG. 4.

TABLE 3A Binding Activity at the Human Ghrelin Receptor for Compounds ofthe Invention Cmpd X R₁ R₂ m R₇ R₃ R₄ n  1 N—H H

0 CH₃ H H 0  2 N—H H

0 H CH₃ H 0  3 N—H H

0 CH₃ H H 0  4 N—H H

0 CH₃ H CH₃ 0  5 N—H H

0 CH₂CH₃ H H 0  6 N—H H

0 CH₃ H H 0  7 N—H H

0 CH₃ H H 0  8 N—H H

0 H

0  9 N—H H

0 H

0  10 N—H H

0 CH₃ H H 0  11 N—H H

0 CH₃ H H 0  12 N—H

H 0 H H

0  13 N—H

H 0 H H

0  14 N—H H

0 H CH₃ H 0  15 N—H H

0 CH₃ CH₃ H 0  16 N—H H

0 CH₃ CH₃ H 0  17 N—H H

0 CH₃ CH₃ H 0  18 N—H

0 H

0  19a N—H H

0 CH₃ CH₃ H 0  19b diastereomer  20 N—H H

0 H

0  21 N—H H

0 H

0  22 N—H H

0 H

0  23 N—H H

0 CH₃ CH₃ H 0  24 N—H H

0 CH₃ CH₃ H 0  25 N—H H

0 CH₃ CH₃ H 0  26 N—H H

0 CH₃ CH₃ H 0  27 N—H H

0 CH₃ CH₃ H 0  28 N—H H

0 CH₃ CH₃ H 0  29 N—H H

0 CH₃ CH₃ H 0  30 N—H H

0 CH₃ CH₃ H 0  31 N—H H

0 CH₃ CH₃ H 0  32 N—H H

0 CH₃ CH₃ H 0  33 N—H H

0 CH₃ CH₃ H 0  34 N—H H

0 CH₃ CH₃ H 0  35 N—H H

0 CH₃ CH₃ H 0  36 N—H H

0 CH₃ CH₃ H 0  37a N—H H

0 CH₃ CH₃ H 0  37b diastereomer  38 N—H H

0 CH₃ CH₃ H 0  39 N—H H

0 CH₃ H H 0  40 N—H H

0 CH₃ CH₃ H 0  41 N—H H

0 CH₃

H 0  42 N—H H

0 CH₃ CH₃ H 0  43 N—H H

0 CH₂CH₃ CH₃ H 0  44 N—H H

0 H

0  45 N—H H

0 H

0  46 N—H H

0 H

0  47 N—H H

0 H

0  48 N—H H

0 H

0  49 N—H H

0 CH₃ H H 0  50 N—H H

0 CH₃ H H 0  51 N—H H

0 CH₃ H H 0  52 N—H H

0 CH₃ H H 0  53 N—H H

0 CH₃ H H 0  54 N—H H

0 CH₃ H H 0  55 N—H

H 0 CH₃ H H 0  56 N—H

H 0 CH₃ H H 0  57 N—H H

0 CH₃ H H 0  58 N—Ac H

0 CH₃ H H 0  59 N—H H

0 H H CH₃ 0  60 N—H H

0 H CH₃ H 0  61 N—H H

0 H H H 0  62 N—H H

0 H H

0  63 N—H H

0 H

H 0  64 N—H H

0 H H

0  65 N—H H

0 H

H 0  66 N—H H

0 H CH₃ CH₃ 0  67 N—H H

0 H

0  68 N—H H

0 H H

0  69 N—H H

0 H

H 0  70 N—H H

0 H H

0  71 N—H H

0 H

H 0  72 N—H H CH₃ 0 CH₃ H H 0  73 N—H H

0 CH₃ H H 0  74 N—H H

0 CH₃ H H 0  75 N—H H

0 CH₃ H H 0  76 N—H H

0 CH₃ H H 0  77 N—H H

0 CH₃ H H 0  78 N—H H

0 CH₃ H H 0  79 N—H H

0 CH₃ H CH₃ 0  80 N—H H H 0 CH₃ H H 0  81 N—H H

0 CH₃ H H 0  82 N—H H

0 CH₃ H H 0  83 N—H H

0 CH₃ H H 0  84 N—H H

0 CH₃ H H 0  85 N—H H

0 CH₃ H H 0  86 N—H H

0 CH₃ H H 0  87 N—H H

0 H

0  88 N—H H

0 H

0  89 N—H H

0 H

0  90 N—H H

0 H

0  91 N—H H

0 H

0  92 N—H H

0 H

0  93 N—H H

0 H H CH₃ 0  94 N—H H

0 H CH₃ H 0  95 N—H H

0 H CH₃ CH₃ 0  96 N—H

H 0 H

0  97 N—H H

0 H

0  98 N—H

H 0 H

0  99 N—Ac H

0 H

0 100 N—H H CH₃ 0 H

0 101 N—H H

0 H

0 102 N—H H

0 H

0 103 N—H H

0 H

0 104 N—H H

0 H

0 105 N—H H

0 H

0 106 N—H H

0 H

0 107 N—H H

0 H

0 108 N—H H

0 H

0 109 N—H H

0 H

0 110 N—H H

0 H

0 111 N—H H

0 H

0 112 N—H H H 0 H

0 113 N—H H

0 H

0 114 N—H H

0 H

0 115 N—H H

0 H

0 116 N—H H

0 H

0 117 N—H H

0 CH₃ CH₃ H 0 118 N—H H

0 CH₃ CH₃ H 0 119 N—H H

0 CH₃ CH₃ H 0 120 N—H H

0 CH₃ CH₃ H 0 121 N—H

0 CH₃ CH₃ H 0 122 N—H H

0 H

0 123 N—H H

0 H

0 124 N—H H

0 H

0 125 N—H H

0 H

0 126 N—H H

0 H

0 127 N—H H

0 H

0 128 N—H H

0 H

0 129 N—H H

0 H

0 130 N—H H

0 H

0 131 N—H H

0 H

0 132 N—H H

0 H

0 133 N—H H

0 H

0 134 N—H H

0 H

0 135 N—H H

0 H

0 136a N—H H

0 H

0 136b diastereomer 137 N—H H

0 H

0 138 N—H H

0 H

0 139 N—H H

0 H

0 140 N—H H

0 H

0 141 N—H H

0 H

0 142 N—H H

0 H

0 143 N—H H

0 H

0 144 N—H H

0 CH₃

H 0 145a N—H H

0 CH₃ H

0 145b diastereomer 146a N—H H

0 CH₃ H

0 146b diastereomer 147 N—H H

0 CH₃

H 0 148 N—H H

0 CH₃ H

0 149 N—H H

0 CH₃

H 0 150a N—H H

0 CH₃ H

0 150b diastereomer 151 N—H H

0 H

H 0 152a N—H H

0 CH₃ H

0 152b diastereomer 153 N—H H

0 H

0 154 N—H H

0 H

0 155 N—H H

0 H

0 156 N—H H

0 H

0 157 N—H H

0 H

0 158 N—H H

0 H

0 159 N—H H

0 H

0 160a N—H H

0 H

0 160b diastereomer 161a N—H H

0 H

0 161b diastereomer 162a N—H H

0 H

0 162b diastereomer 163 N—H H

0 H

0 164 N—H H

0 H

0 165 N—H H

0 H

0 166 N—H H

0 H

0 167 N—H H

0 H

0 168 N—H H

0 H

0 169 N—H H

0 CH₃ CH₃ H 0 170 N—H H

0 CH₃ CH₃ H 0 171 N—H H

0 CH₃ CH₃ H 0 172 N—H H

0 CH₃ CH₃ H 0 173 N—H H

0 CH₃ CH₃ H 0 174 N—H H

0 CH₃ CH₃ H 0 175 N—H H

0 CH₃ CH₃ H 0 176 N—H H

0 CH₃ CH₃ H 0 177 N—H H

0 CH₃ CH₃ H 0 178 N—H H

0 CH₃ CH₃ H 0 179 N—H H

0 CH₃ CH₃ H 0 180 N—H H

0 CH₃ CH₃ H 0 181 N—H H

0 CH₃ CH₃ H 0 182a N—H H

0 CH₃ CH₃ H 0 182b diastereomer 183 N—H H

0 CH₃ CH₃ H 0 184 N—H H

0 CH₃ CH₃ H 0 184 diastereomer 185 N—H H

0 CH₃ CH₃ H 0 186 N—H H

0 CH₃ CH₃ H 0 187 N—H H

0 CH₃ CH₃ H 0 188 N—H H

0 CH₃ CH₃ H 0 189a N—H H

0 CH₃ CH₃ H 0 189b diastereomer 190 N—H H

0 CH₃ CH₃ H 0 191 N—H H

0 CH₃ CH₃ H 0 192 N—H H

0 CH₃ CH₃ H 0 193 N—H H

0 CH₃ CH₃ H 0 194a N—H H

0 CH₃ CH₃ H 0 194b diastereomer 195 N—H H

0 CH₃ CH₃ H 0 196 N—H H

0 CH₃ CH₃ H 0 197 N—H H

0 CH₃ CH₃ H 0 199 N—H H

0 H

0 200 N—H H

0 H

0 201 N-Me H

0 CH₃ CH₃ H 0 202 N—Ac H

0 CH₃ CH₃ H 0 203 N-Me H

0 H

0 204 N—Ac H

0 H

0 205 N—H H

0 CH₃ CH₃ H 0 206 N—H H

0 CH₃ CH₃ H 0 207 N—H H

0 H

0 208a N—H H

0 H

0 208b diastereomer 209 N—H H

0 CH₃ CH₃ H 0 210 N—H H

0 H

0 211 N—H H

0 H

0 212 N—H H

0 CH₃ H

0 213 N—H H

0 H

H 0 214 N—H H

0 CH₃ CH₃ H 0 215 N—H H

0 H

H 0 216 N—H H

0 H

0 218 N—H

0 H

0 219 N—H H

0 H

0 K_(i) Cmpd Z₁ R₅ R₆ p Z₂ T (nM)  1 N—H

H 0 N—H

B  2 N—H

H 0 N—H

C  3 N—H

H 0 N—H

C  4 N—H

H 0 N—H

B  5 N—H

H 0 N—H

C  6 N—H

H 0 N—H

C  7 N—H

H 0 N—H

C  8 N—H H

0 N—H

B  9 N—H H

0 N—H

C  10 N—H

H 0 N—H

B  11 N—H

H 0 N—H

B  12 N—H H

0 N—H

C  13 N—H H

0 N—H

C  14 N—H H

0 N—H

C  15 N—H

H 0 N—H

A  16 N—H

H 0 N—H

A  17 N—H

H 0 N—H

A  18 N—H H

0 N—H

B  19a N—H H

0 N—H

A  19b C  20 N—H H

0 N—H

A  21 N—H H

0 N—H

A  22 N—H H

0 N—H

B  23 N—H

H 0 N—H

A  24 N—H

H 0 N—H

A  25 N—H

H 0 N—H

A  26 N—H

H 0 N—H

A  27 N—H

H 0 N—H

A  28 N—H

H 0 N—H

B  29 N—H

H 0 N—H

B  30 N—H

H 0 N—H

A  31 N—H

H 0 N—H

A  32 N—H

H 0 N—H

B  33 N—H

H 0 N—H

C  34 N—H

H 0 N—H

B  35 N—H

H 0 N—H

B  36 N—H

H 0 N—H

B  37a N—H

H 0 N—H

B  37b B  38 N—H

H 0 N—H

B  39 N—H

H 0 N—H

B  40 N—H

H 0 N—H

A  41 N—H

H 0 N—H

B  42 N—H

H 0 N—H

A  43 N—H

H 0 N—H

B  44 N—H H

0 N—H

G  45 N—H H

0 N—H

G  46 N—H H

0 N—H

G  47 N—H H

0 N—H

C  48 N—H H

0 N—H

G  49 N—H CH₃ H 0 N—H

G  50 N—H

H 0 N—H

G  51 N—H H H 0 N—H

G  52 N—H

H 0 N—H

C  53 N—H

H 0 N—H

G  54 N—H

H 0 N—H

G  55 N—H

H 0 N—H

D  56 N—H H

0 N—H

G  57 N—H H

0 N—H

C  58 N—H

H 0 N—H

G  59 N—H

H 0 N—H

D  60 N—H

H 0 N—H

C  61 N—H

H 0 N—H

C  62 N—H

H 0 N—H

D  63 N—H

H 0 N—H

G  64 N—H

H 0 N—H

G  65 N—H

H 0 N—H

D  66 N—H

H 0 N—H

C  67 N—H

H 0 N—H

C  68 N—H

H 0 N—H

D  69 N—H

H 0 N—H

G  70 N—H

H 0 N—H

G  71 N—H

H 0 N—H

G  72 N—H

H 0 N—H

D  73 N—H

H 0 N—H

G  74 N—H

H 0 N—H

D  75 N—H

H 0 N—H

C  76 N—H

H 0 N—H

G  77 N—H

H 0 N—H

C  78 N—H

H 0 N—H

G  79 N—H

H 0 N—H

C  80 N—H

H 0 N—H

G  81 N—H

H 0 N—H

G  82 N—H

H 0 N—H

G  83 N—H

H 0 N—H

G  84 N—H

H 0 N—H

D  85 N—H

H 0 N—H

G  86 N—H

H 0 N—H

G  87 N—H H CH₃ 0 N—H

G  88 N—H H

0 N—H

D  89 N—H H

0 N—H

D  90 N—H H

0 N—H

D  91 N—H H

0 N—H

G  92 N—H H

0 N—H

G  93 N—H H

0 N—H

D  94 N—H H

0 N—H

D  95 N—H H

0 N—H

D  96 N—H H

0 N—H

G  97 N—H

H 0 N—H

C  98 N—H

H 0 N—H

G  99 N—H H

0 N—H

G 100 N—H H

0 N—H

C 101 N—H H

0 N—H

C 102 N—H H

0 N—H

C 103 N—H H

0 N—H

G 104 N—H H

0 N—H

G 105 N—H H

0 N—H

C 106 N—H H

0 N—H

G 107 N—H H

0 N—H

G 108 N—H H

0 N—H

D 109 N—H H

0 N—H

D 110 N—H H

0 N—H

G 111 N—H H

0 N—H

C 112 N—H H

0 N—H

D 113 N—H H

0 N—H

C 114 N—H H

0 N—H

G 115 N—H H

0 N—H

G 116 N—H H

0 N—H

D 117 N—H

H 0 N—H

B 118 N—H

H 0 N—H

B 119 N—H

H 0 N—H

C 120 N—H

H 0 N—H

B 121 N—H

H 0 N—H

G 122 N—H H

0 N—H

C 123 N—H H

0 N—H

C 124 N—H H

0 N—H

D 125 N—H H

0 N—H

G 126 N—H H

0 N—H

C 127 N—H H

0 N—H

C 128 N—H H

0 N—H

G 129 N—H H

0 N—H

G 130 N—H H

0 N—H

D 131 N—H H

0 N—H

C 132 N—H H

0 N—H

F 133 N—H H

0 N—H

F 134 N—H H

0 N—H

C 135 N—H H

0 N—H

C 136a N—H H

0 N—H

B 136b C 137 N—H H

0 N—H

B 138 N—H H

0 N—H

B 139 N—H H

0 N—H

C 140 N—H H

0 N—H

C 141 N—H H

0 N—H

C 142 N—H H

0 N—H

C 143 N—H H

0 N—H

C 144 N—H

H 0 N—H

C 145a N—H

H 0 N—H

C 145b F 146a N—H

H 0 N—H

F 146b F 147 N—H

H 0 N—H

F 148 N—H

H 0 N—H

F 149 N—H

H 0 N—H

D 150a N—H

H 0 N—H

C 150b G 151 N—H

H 0 N—H

F 152a N—H

H 0 N—H

C 152b C 153 N—H H

0 N—H

B 154 N—H H

0 N—H

B 155 N—H H

0 N—H

E 156 N—H H

0 N—H

B 157 N—H H

0 N—H

C 158 N—H H

0 N—H

F 159 N—H H

0 N—H

B 160a N—H H

0 N—H

F 160b F 161a N—H H

0 N—H

F 161b F 162a N—H H

0 N—H

D 162b G 163 N—H H

0 N—H

G 164 N—H H

0 N—H

C 165 N—H H

0 N—H

G 166 N—H H

0 N—H

G 167 N—H H

0 N—H

G 168 N—H

0 N—H

C 169 N—H

H 0 N—H

B 170 N—H

H 0 N—H

B 171 N—H

H 0 N—H

B 172 N—H H

0 N—H

G 173 N—H

H 0 N—H

C 174 N—H

H 0 N—H

C 175 N—H

H 0 N—H

C 176 N—H

H 0 N—H

B 177 N—H

H 0 N—H

B 178 N—H

H 0 N—H

C 179 N—H

H 0 N—H

C 180 N—H

H 0 N—H

C 181 N—H

H 0 N—H

G 182a N—H

H 0 N—H

G 182b G 183 N—H

H 0 N—H

G 184 N—H

H 0 N—H

C 184 C 185 N—H

H 0 N—H

C 186 N—H

H 0 N—H

C 187 N—H

H 0 N—H

C 188 N—H

H 0 N—H

F 189a N—H

H 0 N—H

C 189b C 190 N—H

H 0 N—H

B 191 N—H

H 0 N—H

C 192 N—H

H 0 N—H

B 193 N—H

H 0 N—H

C 194a N—H

H 0 N—H

C 194b C 195 N—H

H 0 N—H

B 196 N—H

H 0 N—H

G 197 N—H

H 0 N—H

C 199 N—H H

0 N—H

C 200 N—H H

0 N—H

B 201 N—H

H 0 N—H

C 202 N—H

H 0 N—H

G 203 N—H H

0 N—H

D 204 N—H H

0 N—H

G 205 N—H

H 0 N—H

G 206 N—H

H 0 N—H

G 207 N—H H

0 N—H

G 208a N—H H

0 N—H

B 208b 0 N—H

B 209 N—H

H 0 N—H

C 210 N—H H

0 N—H

F 211 N—H H

0 N—H

F 212 N—H

H 0 N—H

C 213 N—H

H 0 N—H

F 214 N—H

H 0 N—H

C 215 N—H

H 0 N—H

D 216 N—H H

0 N—H

D 218 N—H H

0 N—H

B 219 N—H H

0 N—H

C Binding activity determined using standard method, expressed asfollows: A = 0.1-10 nM; B = 10-100 nM; C = 0.1-1.0 μM; D = 1-10 μM; E >500 nM (highest concentration tested); F > 1 μM (highest conscentrationtested); G > 10 μM (or no activity at highest concentration tested)

TABLE 38 Binding Activity at the Human Ghrelin Receptor forRepresentative Compounds of the Invention Compound R₂ R₃ R₄ R₇ R₅ R₆Tether Ki (nm) 298

CH3 H CH3

H

B 299

CH3 H CH3

H

A 301

H H

B 303

H H

B 305

CH3 H CH3

H

C   306a

CH3 H CH3

H

B  306b diastereomer B 307

CH3 H CH3

H

C 308

CH3 H CH3

H

A 309

CH3 H CH3

H

A 310

CH3 H CH3

H

B 311

CH3 H CH3

H

B 312

CH3 H CH3

H

A 313

CH3 H CH3

H

B 314

CH3 H CH3

H

A 315

CH3 H CH3

H

A 316

CH3 H CH3

H

B 317

CH3 H CH3

H

B 318

CH3 H CH3

H

A 319

CH3 H CH3

H

A 320

CH3 H CH3

H

A 321

CH3 H CH3

H

B 322

CH3 H CH3

H

A 323

CH3 H CH3

H

C 324

CH3 H CH3

H

B 325

H H

B 326

H H

B   327a

H H

B  327b diastereomer C 328

H H

B 329

H H

B 330

H H

A   331a

H H

B  331b diastereomer C   332a

H H

B  332b diastereomer C 333

H H

C 335

CH3 H CH3

H

B 336

CH3 H CH3

H

C 337

CH3 H CH3

H

C 338

CH3 H CH3

H

C 339

CH3 H CH3

H

C 340

CH3 H CH3

H

B 341

H H

B 342

H H

C 343

H H

C 344

H H

C   345a

H H

C  345b diastereomer B 346

H H

B 347

H H

C   348a

CH3 CH3 H H

C  348b diastereomer C   353a

CH3 H CH3

H

B  353b diasteromer B 354

CH3 H CH3

H

B 355

CH3 H CH3

H

B 356

CH3 H CH3

H

C 357

CH3 H CH3

H

C   358a

H H

B  358b diastereoamer C 359

H H

C 360

H H

C 361

H H

C 362

H H

C 363

H H

C 364

H H

C 365

H H

C 366

H H

C 367

CH3 H CH3

H

B   368a

H H

B  368b diastereomer B 369

H H

B 370

H H

C 371

H H

B 372

CH3 H CH3

H

A 373

CH3 H CH3

H

B 374

CH3 H CH3

H

B 375

CH3 H CH3

H

C 376

CH3 H CH3

H

C 377

CH3 H CH3

H

C 378

CH3 H CH3

H

C 379

CH3 H CH3

H

B 380

H H

C 381

H H

B 382

H H

B 383

H H

C 384

H H

C 385

H H

C 386

H H

C 387

H H

C 388

H H

A   389a

CH3 H CH3

H

B  389b diastereomer B 390

H H

C 391

CH3 H CH3

H

A 392

H H

B 393

H H

C 394

CH3 H CH3

H

A 395

H H

B 398

CH3 H CH3

H

C   399a

H H

C  399b diastereomer A 400

CH3 H CH3

H

B 401

CH3 H CH3

H

A   402a

H H

B  402b diastereomer B Binding activity determined using standardmethod, expressed as follows: A = 0.1-10 nM; B = 10-100 nM; C = 0.1-1.0μM

TABLE 3C Binding Activity at the Human Ghrelin Receptor forRepresentative Compounds of the Invention Com- Ki pound Structure (nM)18

B 334

B 349

B 350

C 351

B 352

C 396

B 397

C

TABLE 3D Binding Activity at the Human Ghrelin Receptor forRepresentative Compounds of the Invention Compound R₁ R₂ R₃ R₄ R₇ R₅ R₆Tether Ki (nM) 435 H

CH3 H CH3

H

B 436 H

CH3 H CH3

H

B 437

H H

A 438 H

H H

D 439 H

H H

D 440 H

H CH3

C 441 H

H H

D   442a H

H H

E  442b diastereomer E   443a H

H H

E  443b diastereomer E   444a H

H H

E  444b diastereomer E 445 H

CH3 H CH3

H

B   446a H

CH3 H CH3

H

D  446b diastereomer D 447 H

H H

D 448 H

H H CH3 H

D 449 H

H H

D For all compounds, designations are based upon formula I, X = Z₁ = Z₂= NH, m = n = p = 0 Binding activity determined using standard method,expressed as follows: A = 0.1-10 nM; B = 10-100 nM; C = 0.1-1.0 μM; D =1.0-10 μM; E > 10 μM

TABLE 3E Binding Activity at the Human Ghrelin Receptor forRepresentative Compounds of the Invention Compound K_(i)

D 220

C 221

D 222

D 223

G 224

C 225

B 226

C 227

G 228

B 229

C 230 230 diasteromer D Binding activity determined using standardmethod, expressed as follows: A = 0.1-10 nM; B = 10-100 nM; C = 0.1-1.0μM; D = 1-10 μM; E > 500 nM (highest concentration tested); F > 1 μM(highest concentration tested); G > 10 μM (or no activity at highestconcentration tested)B. Aequorin Functional Assay (Ghrelin Receptor)

The functional activity of compounds of the invention found to bind tothe GHS-R1a receptor can be determined using the method described belowwhich can also be used as a primary screen for ghrelin receptor activityin a high throughput fashion. (LePoul, E.; et al. Adaptation of aequorinfunctional assay to high throughput screening. J. Biomol. Screen. 2002,7, 57-65; Bednarek, M. A.; et al. Structure-function studies on the newgrowth hormone-releasing peptide ghrelin: minimal sequence of ghrelinnecessary for activation of growth hormone secretagogue receptor 1a. J.Med. Chem. 2000, 43, 4370-4376; Palucki, B. L.; et al.Spiro(indoline-3,4′-piperidine) growth hormone secretagogues as ghrelinmimetics. Bioorg. Med. Chem. Lett. 2001, 11, 1955-1957.)

Materials

Membranes were prepared using AequoScreen™ (EUROSCREEN, Belgium) celllines expressing the human ghrelin receptor (cell line ES-410-A;receptor accession #60179). This cell line is typically constructed bytransfection of the human ghrelin receptor into CHO-K1 cellsco-expressing G_(α16) and the mitochondrially targeted Aequorin (Ref#ES-WT-A5).

-   1. Ghrelin (reference agonist; Bachem, #H-4864)-   2. Assay buffer: DMEM (Dulbecco's Modified Eagles Medium) containing    0.1% BSA (bovine serum albumin; pH 7.0).-   3. Coelenterazine (Molecular Probes, Leiden, The Netherlands).    Final test concentrations (N=8) for compounds of the invention:    10, 1, 0.3, 0.1, 0.03, 0.01, 0.003, 0.001 μM.    Compound Handling

Stock solutions of compounds (10 mM in 100% DMSO) were provided frozenon dry ice and stored at −20° C. prior to use. From the stock solution,mother solutions were made at a concentration of 500 μM by 20-folddilution in 26% DMSO. Assay plates were then prepared by appropriatedilution in DMEM medium containing 0.1% BSA. Under these conditions, themaximal final DMSO concentration in the assay was <0.6%.

Cell Preparation

AequoScreen™ cells were collected from culture plates with Ca²⁺ andMg²⁺-free phosphate buffered saline (PBS) supplemented with 5 mM EDTA,pelleted for 2 min at 1000×g, re-suspended in DMEM—Ham's F12 containing0.1% BSA at a density of 5×10⁶ cells/mL, and incubated O/N at rt in thepresence of 5 μM coelenterazine. After loading, cells were diluted withassay buffer to a concentration of 5×10⁵ cells/mL.

Assay Protocol

For agonist testing, 50 μL of the cell suspension was mixed with 50 μLof the appropriate concentration of test compound or ghrelin (referenceagonist) in 96-well plates (duplicate samples). Ghrelin (referenceagonist) was tested at several concentrations concurrently with the testcompounds in order to validate the experiment. The emission of lightresulting from receptor activation in response to ghrelin or testcompounds was recorded using the Hamamatsu FDSS 6000 reader (HamamatsuPhotonics K.K., Japan).

Analysis and Expression of Results

Results were expressed as Relative Light Units (RLU). Concentrationresponse curves were analyzed using GraphPad Prism (GraphPad Software,San Diego, Calif.) by non-linear regression analysis (sigmoidaldose-response) based on the equation E=E_(max)/(1+EC₅₀/C)n where E wasthe measured RLU value at a given agonist concentration (C), E_(max) wasthe maximal response, EC₅₀ was the concentration producing 50%stimulation and n was the slope index. For agonist testing, results foreach concentration of test compound were expressed as percent activationrelative to the signal induced by ghrelin at a concentration equal tothe EC₈₀ (i.e. 3.7 nM). EC₅₀, Hill slope and % E_(max) values arereported.

The data show that the representative compounds examined act as agonistsat the ghrelin receptor and are devoid of antagonist activity at theconcentrations studied. In addition, these compounds were demonstratedto have high selectivity for the ghrelin receptor versus its closestcounterpart, the motilin receptor, with which it has 52% sequencehomology. (Feighner, S. D.; Tan, C. P.; McKee, K. K.; Palyla, O. C.;Hreniuk, D. L.; Pong, S.-S.; Austin, C. P.; Figueroa, D.; MacNeil, D.;Cascieri, M. A.; Nargund, R.; Bakshi, R.; Abramovitz, M.; Stocco, R.;Kargman, S.; O'Neill, G.; van der Ploeg, L. H. T.; Evans, J.; Patchett,A. A.; Smith, R. G.; Howard, A. D. Receptor for motilin identified inthe human gastrointestinal system. Science 1999, 284, 2184-2188.) Theendogenous peptides themselves have 36% of residues in common andghrelin was even identified at one point as motilin-related peptide.(Tomasetto, C.; Karam, S. M.; Ribieras, S.; Masson, R.; Lefebvre, O.;Staub, A.; Alexander, G.; Chenard, M. P.; Rio, M. C. Identification andcharacterization of a novel gastric peptide hormone: the motilin-relatedpeptide. Gastroenterology 2000, 119, 395-405.) Ghrelin does not interactappreciably at the motilin receptor, although GHRP-6 does. (Depoortere,I.; Thijs, T.; Thielemans, L.; Robberecht, P.; Peeters, T. L.Interaction of the growth hormone-releasing peptides ghrelin and growthhormone-releasing peptide-6 with the motilin receptor in the rabbitgastric antrum. J. Pharmacol. Exp. Ther. 2003, 305, 660-667.) On theother hand, motilin itself as been demonstrated to have someGH-releasing effects. (Samson, W. K.; Lumpkin, M. D.; Nilayer, G.;McCann, S. M. Motilin: a novel growth hormone releasing agent. BrainRes. Bull. 1984, 12, 57-62.)

The level of agonist activity and selectivity for representativecompounds of the invention are shown below in Table 4.Concentration-response results for exemplary compounds 1-5 are presentedin FIG. 5.

TABLE 4 Functional Assay at the Human Ghrelin Receptor and SelectivityResults Compound^(a) K_(i) (nM)* EC₅₀ (nM)** Selectivity^(b)  1 B BB 142/1  2 C BB nd  3 C BB nd  4^(g) B^(c) AA 3012/1  5 C BB nd  6 C AA 71/1  7 C AA >100/1  8^(f) B^(d) AA  200/1  9^(g) C^(e) BB  117/1  10 BAA  304/1  11^(f) B BB nd  15 A nd >1700/1    16 A nd >2000/1    17 A AA2500/1  18 B AA  222/1  19 C nd >1700/1    20 A AA 1044/1  21 A AA1078/1  23 A AA 30,000/1    24 A nd 3039/1  25 A AA 28,000/1    26 AAA >7700/1    27^(e) A AA >7100/1    28 B AA nd  30 A AA 13,000/1    31A AA 4900/1  34 B nd >1000/1    35 B AA nd  36 B BB nd  37a B AA >800/1 37b B BB nd  38 B BB nd  39^(f) A BB 3400/1  40 A AA >3300/1    42 A nd4300/1  43 B nd 3700/1  47 C AA nd  97 B BB nd 111 B BB nd 113^(g) B BBnd 140 C BB nd 141 C AA nd 153 B AA nd 154 B AA nd 156 B AA nd 168 C CCnd 170 B BB nd 176 B AA  105/1 177 B AA >100/1 178 C BB nd 184a C BB 28/1 184b C^(e) BB nd 186 C BB nd 191 C BB nd 192 B BB nd 193 C BB nd194a C BB nd 194b C BB nd 195 B AA nd 197 C CC  100/1 214 C BB nd 226 BCC nd 298 B AA 3100/1 299 A AA nd 306a B AA  714/1 311 B nd  21/1 314 AAA >5500/1   318 A AA nd 322 A AA nd 334 B AA  346/1 345a B AA >159/1346 B AA nd 351 B AA  450/1 354 B AA nd 358a B AA nd 363 C nd  35/1 367B AA nd 368a A CC nd 372 A AA 2500/1 374 B AA  250/1 382 B BB  74/1 388A AA  400/1 389a B BB  450/1 394 A BB 1700/1 399a A CC  300/1 445 B AAnd ^(a)All compounds were tested as their TFA salts unless otherwisenoted. ^(b)Versus the human motilin receptor (nd = not determined)^(c)Average of six (6) experiments ^(d)Average of four (4) experiments^(e)Average of two (2) experiments ^(f)HCl salt ^(g)Formate salt*Binding activity determined using standard method and expressed as A =0.1-10 nM; B = 10-100 nM; C = 100-1000 nM **Functional activitydetermined using standard method and expressed as AA = 1-100 nM; BB =100-1000 nM; CC >1000 nM; nd = not determinedC. Cell Culture Assay for Growth Hormone Release

Cell culture assays for determining growth hormone release can beemployed as described in Cheng, et al. Endocrinology 1989, 124,2791-2798. In particular, anterior pituitary glands are obtained frommale Sprague-Dawley rats and placed in cold culture medium. Thesepituitaries are sectioned, for example into one-eighth sections, thendigested with trypsin. Cells are collected after digestion, pooled, andtransferred into 24 well plates (minimum 200,000 cells per well). Aftera monolayer of cells has formed, generally after at least 4 d inculture, the cells are washed with medium prior to exposure to the testsamples and controls. Varying concentrations of the test compounds andof ghrelin as a positive control were added to the medium. The cells areleft for 15 min at 37° C., then the medium removed and the cells storedfrozen. The amount of GH release was measured utilizing a standardradioimmunoassay as known to those in the art.

D. Pharmacokinetic Analysis of Representative Compounds of the Invention

The pharmacokinetic behavior of compound of the invention can beascertained by methods well known to those skilled in the art.(Wilkinson, G. R. “Pharmacokinetics: The Dynamics of Drug Absorption,Distribution, and Elimination” in Goodman & Gilman's The PharmacologicalBasis of Therapeutics, Tenth Edition, Hardman, J. G.; Limbird, L. E.,Eds., McGraw Hill, Columbus, Ohio, 2001, Chapter 1.) The followingmethod was used to investigate the pharmacokinetic parameters(elimination half-life, total plasma clearance, etc.) for intravenous,subcutaneous and oral administration of compounds of the presentinvention.

Collection of Plasma

Rats: male, Sprague-Dawley (˜250 g)

Rats/Treatment Group: 6 (2 subsets of 3 rats each, alternate bleeds)

Each sample of test compound was sent in solution in a formulation (suchas with cyclodextrin) appropriate for dosing. It will be appreciated byone skilled in the art that appropriate modifications to this protocolcan be made as required to adequately test the properties of thecompound under analysis.Typical Dose

-   1. Intravenous (i.v.): 2 mg/kg-   2. Subcutaneous (s.c). 2 mg/kg-   3. Oral (p.o.): 8 mg/kg

TABLE 5 Representative Intravenous Blood Sampling Schedule. Subset Time(min.) relative to Dose Administration ID Pre-dose 1 5 20 60 90 120 180240 300 Subset ✓ ✓ ✓ ✓ ✓ A Subset ✓ ✓ ✓ ✓ ✓ B

TABLE 6 Representative Subcutaneous & Oral Blood Sampling Schedule.Subset Time (min.) relative to Dose Administration ID Pre-dose 5 15 3060 90 120 180 270 360 Subset ✓ ✓ ✓ ✓ ✓ A Subset ✓ ✓ ✓ ✓ ✓ BPlasma Collection

-   1. Same protocol for all dosing groups-   2. For each group, 2 subsets (A and B) of 3 rats/subset

At the time intervals indicated above, 0.7 mL of blood were collectedfrom each animal. It is expected that this volume of blood will yield asample of at least 0.3 mL of plasma. EDTA was used as an anti-coagulantfor whole blood collection. Whole blood samples were chilled andimmediately processed by centrifugation to obtain plasma.

Plasma samples were stored frozen (−70° C.) until analysis. Analyticaldetection of parent compound in plasma samples performed by LC-MS afteran appropriate preparation protocol: extraction using solid phaseextraction (SPE) cartridges (Oasis MCX, Oasis HLB) or liquid-liquidextraction.

HPLC-MS Method

Column: Atlantis dC18 from Waters 2.1×30 mm

Mobile phases:

A: 95% MeOH, 5% water, 0.1% TFA

B: 95% water, 5% MeOH) 0.1% TFA

Flow: 0.5 mL/min

Gradient (linear):

Time (min) A B 0 30% 70% 0.5 30% 70% 2.8 100% 0% 3.8 100% 0% 4.0 30% 70%5.0 30% 70%

The analyte was quantitated based upon a standard curve and the methodvalidated with internal standards

TABLE 7 Pharmacokinetic Parameters for Representative Compounds of theInvention Clearance Mode of Elimination (mL/ Bioavailability CompoundAdministration^(a) (t_(1/2), min) min/kg) (oral)^(b) 25 i.v. 31 67 na298 i.v. 75 17 na 298 s.c. 66 15 na 298 p.o. 312 14 29% ^(a)i.v. =intravenous (10 time points over 150 min); s.c. = subcutaneous (10 timepoints over 360 min), p.o. = oral (10 time points over 240 min) ^(b)na =not applicable

Results of the time courses for these studies are provided in FIGS.6A-6D.

E. Gastric Emptying

To examine the effects of compounds of the invention in a model forgastroparesis, compounds were evaluated for possible effects on gastricemptying in fasted rats. For example, compounds 25 and 298 at 100 μg/kgcaused a significant increase (≧30%) in gastric emptying relative to thevehicle control group. The relative efficacy (39% increase) of compounds25 and 298 at 100 μg/kg i.v. was similar to concurrently run positivereference agents GHRP-6 at 20 μg/kg i.v. (40% increase) andmetoclopramide at 10 mg/kg i.v. (41% increase). Accordingly, compounds25 and 298 at a dose of 100 μg/kg demonstrated gastrokinetic activity inrats, with efficiency similar to GHRP-6 at 20 μg/kg and metoclopramideat 10 mg/kg. Further, compound 25 also demonstrated gastric emptying at30 μg/kg. This is significantly more potent than other compoundsinteracting at this receptor previously found to enhance GI motility,which were unable to promote gastric emptying at 100 μg/kg (U.S. Pat.No. 6,548,501).

Test Substances and Dosing Pattern

GHRP-6 and test samples were dissolved in vehicle of 9% HPBCD/0.9% NaCl.Immediately following oral administration of methylcellulose (2%)containing phenol red (0.05%) (2 mL/rat), test substances or vehicle (9%HPBCD/0.9% NaCl) were each administered intravenously (i.v.) at a dosingvolume of 5 mL/kg.

Animals

Male Wistar rats were provided by LASCO (A Charles River LicenseeCorporation, Taiwan). Space allocation for 6 animals was 45×23×15 cm.Animals were housed in APEC® cages and maintained in a controlledtemperature (22° C.-24° C.) and humidity (60%-80%) environment with 12 hlight, 12 h dark cycles for at least one week in the laboratory prior tobeing used. Free access to standard lab chow for rats (Lab Diet, RodentDiet, PMI Nutrition International, USA) and tap water was granted. Allaspects of this work including housing, experimentation and disposal ofanimals were performed in general accordance with the Guide for the Careand Use of Laboratory Animals (National Academy Press, Washington, D.C.,1996).

Chemicals

Glucose (Sigma, USA), Metoclopramide-HCl (Sigma, USA), Methylcellulose(Sigma, USA), NaOH (Sodium Hydroxide, Wako, Japan), Pyrogen free saline(Astar, Taiwan), Phenol Red-Sodium salt (Sigma, USA) and Trichloroaceticacid (Merck, USA). Equipment

8-well strip (Costar, USA), 96-well plate (Costar, USA), Animal case(ShinTeh, R. O. C.), Centrifugal separator (Kokusan, H-107, Japan),Glass syringe (1 mL, 2 mL, Mitsuba, Japan), Hypodermic needle (25G×1″,TOP Corporation, Japan), Microtube (Treff, Switzerland), pH-meter(Hanna, USA), Pipetamam (P100, Gilson, France), Pipette tips (Costar,USA), Rat oral needle (Natsume, Japan), Spectra Fluor plus (Austria),Stainless scissors (Klappencker, Germany) and Stainless forceps(Klappencker, Germany).

Assay

Test substances were each administered intravenously to a group of 5O/N-fasted Wistar derived male rats weighing 200±20 g immediately aftermethylcellulose (2%) containing phenol red (0.05%) was administeredorally at 2 mL/animal. The animals were then sacrificed 15 minuteslater. The stomach was immediately removed, homogenized in 0.1 N NaOH (5mL) and centrifuged. Following protein precipitation by 20%trichloroacetic acid (0.5 mL) and re-alkalization of the supernatantwith 0.1 N NaOH, total phenol red remaining in the stomach wasdetermined by a colorimetric method at 560 nm. A 30 percent or more(≧30%) increase in gastric emptying, detected as the decrease in phenolred concentration in the stomach relative to the vehicle control group,is considered significant.

Results for two representative compounds of the invention are shown inFIG. 7 and in the Examples below.

F. Gastric Emptying and Intestinal Transit in Rat Model of PostoperativeIleus

This clinically relevant model for POI is adapted from that of Kalff.(Kalff, J. C.; Schraut, W. H.; Simmons, R. L.; Bauer, A. J. Surgicalmanipulation of the gut elicits an intestinal muscularis inflammatoryresponse resulting in postsurgical ileus. Ann. Surg 1998, 228, 652-663.)Other known models can also be used to study the effect of compounds ofthe invention. (Trudel, L.; Bouin, M.; Tomasetto, C.; Eberling, P.;St-Pierre, S.; Bannon, P.; L'Heureux, M. C.; Poitras, P. Two newpeptides to improve post-operative gastric ileus in dog. Peptides 2003,24, 531-534; (b) Trudel, L.; Tomasetto, C.; Rio, M. C.; Bouin, M.;Plourde, V.; Eberling, P.; Poitras, P. Ghrelin/motilin-related peptideis a potent prokinetic to reverse gastric postoperative ileus in rats.Am. J. Physiol. 2002, 282, G948-G952.)

Animals

-   1. Rat, Sprague-Dawley, male, ˜300 g.-   2. Fasted O/N prior to study.    Induction of post-operative ileus (POI)-   1. Isofluorane anaesthesia under sterile conditions.-   2. Midline abdominal incision.-   3. Intestines and caecum were eviscerated and kept moist with    saline.-   4. The intestines and caecum were manipulated along its entire    length with moist cotton applicators analogous to the ‘running of    the bowel’ in the clinical setting. This procedure was timed to last    for 10 min.-   5. Intestines were gently replaced into the abdomen and the    abdominal wound was stitched closed under sterile conditions.    Dosing-   1. Rat was allowed to recover from isofluorane anaesthesia.-   2. Test compounds (or vehicle) were administered intravenously via    previously implanted jugular catheter.-   3. Immediate intragastric gavage of methylcellulose (2%) labeled    with radioactive ^(99m)Tc, t=0.    Experimental-   1. At t=15 min, animal was euthanized with CO₂.-   2. Stomach and 10 cm sections along the small intestine were    immediately ligated, cut and placed in tubes for measuring of    ^(99m)Tc in gamma counter.-   3. Stomach emptying and small intestinal transit were measured by    calculation of the geometric mean.    Geometric mean=Σ(% total radioactivity×number of segment)/100

Results are depicted in the graph in FIG. 8 and indicate that Compound298 at 100 μg/kg (i.v. n=5) significantly improves postoperative ileusin comparison to POI+vehicle treated rats. Further results are presentedin the Examples below.

G. Growth Hormone Response to Test Compounds

The compounds of the invention likewise can be tested in a number ofanimal models for their effect on GH release. For example, rats (Bowers,C. Y.; Momany, F.; Reynolds, G. A.; Chang, D.; Hong, A.; Chang, K.Endocrinology 1980, 106, 663-667), dogs (Hickey, G.; Jacks, T.; Judith,F.; Taylor, J.; Schoen, W. R.; Krupa, D.; Cunningham, P.; Clark, J.;Smith, R. G. Endocrinology 1994, 134, 695-701; Jacks, T.; Hickey, G.;Judith, F.; Taylor, J.; Chen, H.; Krupa, D.; Feeney, W.; Schoen, W. R.;Ok, D.; Fisher, M.; Wyvratt, M.; Smith, R. J. Endocrinology 1994, 143,399-406; Hickey, G. J.; Jacks, T. M.; Schleim, K. D.; Frazier, E.; Chen,H. Y.; Krupa, D.; Feeney, W.; Nargund, R. P.; Patchett, A. A.; Smith, R.G. J. Endocrinol. 1997, 152, 183-192), and pigs (Chang, C. H.; Rickes,E. L.; Marsilio, F.; McGuire, L.; Cosgrove, S.; Taylor, J.; Chen, H. Y.;Feighner, S.; Clark, J. N.; Devita, R.; Schoen, W. R.; Wyvratt, M.;Fisher, M.; Smith, R. G.; Hickey, G. Endocrinology 1995, 136, 1065-1071;(b) Peschke, B.; Hanse, B. S. Bioorg. Med. Chem. Lett. 1999, 9,1295-1298) have all been successfully utilized for the in vivo study ofthe effects of GHS and would likewise be applicable for investigation ofthe effect of ghrelin agonists on GH levels. The measurement of ghrelinof GH levels in plasma after appropriate administration of compounds ofthe invention can be performed using radioimmunoassay via standardmethods known to those in the art. (Deghenghi, R.; et al. Life Sciences1994, 54, 1321-1328.) Binding to tissue can be studied using whole bodyautoradiography after dosing of an animal with test substance containinga radioactive label. (Ahnfelt-Rønne, I.; Nowak, J.; Olsen, U. B. Dogrowth hormone-releasing peptides act as ghrelin secretagogues?Endocrine 2001, 14, 133-135.)

The following method is employed to determine the temporal pattern andmagnitude of the growth hormone (GH) response to test compounds,administered either systemically or centrally. Results for compound 298demonstrating its lack of effect on GH release are presented graphicallyin FIG. 9. Compound 25 gave similar results. Further results arepresented in the Examples below.

Dosing and Sampling Procedures for In Vivo Studies of GH Release

Adult male Sprague Dawley rats (225-300 g) were purchased from CharlesRiver Canada (St. Constant, Canada) and individually housed on a 12-hlight, 12-h dark cycle (lights on, time: 0600-1800) in a temperature(22±1° C.)- and humidity-controlled room. Purina rat chow (RalstonPurina Co., St. Louis, Mo.) and tap water were freely available. Forthese studies, chronic intracerebroventricular (icv) and intracardiacvenous cannulas were implanted under sodium pentobarbital (50 mg/kg, ip)anesthesia using known techniques. The placement of the icv cannula wasverified by both a positive drinking response to icv carbachol (100ng/10 μl) injection on the day after surgery and methylene blue dye atthe time of sacrifice. After surgery, the rats were placed directly inisolation test chambers with food and water freely available until bodyweight returned to preoperative levels (usually within 5-7 d). Duringthis time, the rats were handled daily to minimize any stress associatedwith handling on the day of the experiment. On the test day, food wasremoved 1.5 h before the start of sampling and was returned at the end.Free moving rats were iv injected with either test sample at variouslevels (3, 30, 300, 1000 μg/kg) or normal saline at two different timepoints during a 6-h sampling period. The times 1100 and 1300 were chosenbecause they reflect typical peak and trough periods of GH secretion, aspreviously documented. The human ghrelin peptide (5 μg, PhoenixPharmaceuticals, Inc., Belmont, Calif.) was used as a positive controlin the experiments and was diluted in normal saline just before use. Toassess the central actions of test compounds on pulsatile GH release, a10-fold lower dose of the test sample or normal saline was administeredicv at the same time points, 1100 and 1300. Blood samples (0.35 mL) werewithdrawn every 15 min over the 6-h sampling period (time: 1000-1600)from all animals. To document the rapidity of the GH response to thetest compound, an additional blood sample was obtained 5 min after eachinjection. All blood samples were immediately centrifuged, and plasmawas separated and stored at −20° C. for subsequent GH assay. To avoidhemodynamic disturbance, the red blood cells were resuspended in normalsaline and returned to the animal after removal of the next bloodsample. All animal studies were conducted under procedures approved byan animal care oversight committee.

GH Assay Method

Plasma GH concentrations were measured in duplicate by double antibodyRIA using materials supplied by the NIDDK Hormone Distribution Program(Bethesda, Md.). The averaged plasma GH values for 5-6 rats per groupare reported in terms of the rat GH reference preparation. The standardcurve was linear within the range of interest; the least detectableconcentration of plasma GH under the conditions used was approximately 1ng/mL. All samples with values above the range of interest werereassayed at dilutions ranging from 1:2 to 1:10. The intra- andinterassay coefficients of variation were acceptable for duplicatesamples of pooled plasma containing a known GH concentration.

4. Pharmaceutical Compositions

The macrocyclic compounds of the present invention or pharmacologicallyacceptable salts thereof according to the invention may be formulatedinto pharmaceutical compositions of various dosage forms. To prepare thepharmaceutical compositions of the invention, one or more compounds,including optical isomers, enantiomers, diastereomers, racemates orstereochemical mixtures thereof, or pharmaceutically acceptable saltsthereof as the active ingredient is intimately mixed with appropriatecarriers and additives according to techniques known to those skilled inthe art of pharmaceutical formulations.

A pharmaceutically acceptable salt refers to a salt form of thecompounds of the present invention in order to permit their use orformulation as pharmaceuticals and which retains the biologicaleffectiveness of the free acids and bases of the specified compound andthat is not biologically or otherwise undesirable. Examples of suchsalts are described in Handbook of Pharmaceutical Salts: Properties,Selection, and Use, Wermuth, C. G. and Stahl, P. H. (eds.), Wiley-VerlagHelvetica Acta, Zürich, 2002 [ISBN 3-906390-26-8]. Examples of suchsalts include alkali metal salts and addition salts of free acids andbases. Examples of pharmaceutically acceptable salts, withoutlimitation, include sulfates, pyrosulfates, bisulfates, sulfites,bisulfites, phosphates, monohydrogenphosphates, dihydrogenphosphates,metaphosphates, pyrophosphates, chlorides, bromides, iodides, acetates,propionates, decanoates, caprylates, acrylates, formates, isobutyrates,caproates, heptanoates, propiolates, oxalates, malonates, succinates,suberates, sebacates, fumarates, maleates, butyne-1,4-dioates,hexyne-1,6-dioates, benzoates, chlorobenzoates, methylbenzoates,dinitrobenzoates, hydroxybenzoates, methoxybenzoates, phthalates,xylenesulfonates, phenylacetates, phenylpropionates, phenylbutyrates,citrates, lactates, γ-hydroxybutyrates, glycollates, tartrates,methanesulfonates, ethane sulfonates, propanesulfonates,toluenesulfonates, naphthalene-1-sulfonates, naphthalene-2-sulfonates,and mandelates.

If an inventive compound is a base, a desired salt may be prepared byany suitable method known to those skilled in the art, includingtreatment of the free base with an inorganic acid, such as, withoutlimitation, hydrochloric acid, hydrobromic acid, hydroiodic, carbonicacid, sulfuric acid, nitric acid, phosphoric acid, and the like, or withan organic acid, including, without limitation, formic acid, aceticacid, propionic acid, maleic acid, succinic acid, mandelic acid, fumaricacid, malonic acid, pyruvic acid, oxalic acid, stearic acid, ascorbicacid, glycolic acid, salicylic acid, pyranosidyl acid, such asglucuronic acid or galacturonic acid, alpha-hydroxy acid, such as citricacid or tartaric acid, amino acid, such as aspartic acid or glutamicacid, aromatic acid, such as benzoic acid or cinnamic acid, sulfonicacid, such as p-toluenesulfonic acid, methanesulfonic acid,ethanesulfonic acid, 2-hydroxyethanesulfonic acid, benzenesulfonic acid,cyclohexyl-aminosulfonic acid or the like.

If an inventive compound is an acid, a desired salt may be prepared byany suitable method known to the art, including treatment of the freeacid with an inorganic or organic base, such as an amine (primary,secondary, or tertiary); an alkali metal or alkaline earth metalhydroxide; or the like. Illustrative examples of suitable salts includeorganic salts derived from amino acids such as glycine, lysine andarginine; ammonia; primary, secondary, and tertiary amines such asethylenediamine, N,N′-dibenzylethylenediamine, diethanolamine, choline,and procaine, and cyclic amines, such as piperidine, morpholine, andpiperazine; as well as inorganic salts derived from sodium, calcium,potassium, magnesium, manganese, iron, copper, zinc, aluminum, andlithium.

The carriers and additives used for such pharmaceutical compositions cantake a variety of forms depending on the anticipated mode ofadministration. Thus, compositions for oral administration may be, forexample, solid preparations such as tablets, sugar-coated tablets, hardcapsules, soft capsules, granules, powders and the like, with suitablecarriers and additives being starches, sugars, binders, diluents,granulating agents, lubricants, disintegrating agents and the like.Because of their ease of use and higher patient compliance, tablets andcapsules represent the most advantageous oral dosage forms for manymedical conditions.

Similarly, compositions for liquid preparations include solutions,emulsions, dispersions, suspensions, syrups, elixirs, and the like withsuitable carriers and additives being water, alcohols, oils, glycols,preservatives, flavoring agents, coloring agents, suspending agents, andthe like. Typical preparations for parenteral administration comprisethe active ingredient with a carrier such as sterile water orparenterally acceptable oil including polyethylene glycol, polyvinylpyrrolidone, lecithin, arachis oil or sesame oil, with other additivesfor aiding solubility or preservation may also be included. In the caseof a solution, it can be lyophilized to a powder and then reconstitutedimmediately prior to use. For dispersions and suspensions, appropriatecarriers and additives include aqueous gums, celluloses, silicates oroils.

The pharmaceutical compositions according to embodiments of the presentinvention include those suitable for oral, rectal, topical, inhalation(e.g., via an aerosol) buccal (e.g., sub-lingual), vaginal, topical(i.e., both skin and mucosal surfaces, including airway surfaces),transdermal administration and parenteral (e.g., subcutaneous,intramuscular, intradermal, intraarticular, intrapleural,intraperitoneal, intrathecal, intracerebral, intracranially,intraarterial, or intravenous), although the most suitable route in anygiven case will depend on the nature and severity of the condition beingtreated and on the nature of the particular active agent which is beingused.

Compositions for injection will include the active ingredient togetherwith suitable carriers including propylene glycol-alcohol-water,isotonic water, sterile water for injection (USP),emulPhor™-alcohol-water, cremophor-EL™ or other suitable carriers knownto those skilled in the art. These carriers may be used alone or incombination with other conventional solubilizing agents such as ethanol,propylene glycol, or other agents known to those skilled in the art.

Where the macrocyclic compounds of the present invention are to beapplied in the form of solutions or injections, the compounds may beused by dissolving or suspending in any conventional diluent. Thediluents may include, for example, physiological saline, Ringer'ssolution, an aqueous glucose solution, an aqueous dextrose solution, analcohol, a fatty acid ester, glycerol, a glycol, an oil derived fromplant or animal sources, a paraffin and the like. These preparations maybe prepared according to any conventional method known to those skilledin the art.

Compositions for nasal administration may be formulated as aerosols,drops, powders and gels. Aerosol formulations typically comprise asolution or fine suspension of the active ingredient in aphysiologically acceptable aqueous or non-aqueous solvent. Suchformulations are typically presented in single or multidose quantitiesin a sterile form in a sealed container. The sealed container can be acartridge or refill for use with an atomizing device. Alternatively, thesealed container may be a unitary dispensing device such as a single usenasal inhaler, pump atomizer or an aerosol dispenser fitted with ametering valve set to deliver a therapeutically effective amount, whichis intended for disposal once the contents have been completely used.When the dosage form comprises an aerosol dispenser, it will contain apropellant such as a compressed gas, air as an example, or an organicpropellant including a fluorochlorohydrocarbon or fluorohydrocarbon.

Compositions suitable for buccal or sublingual administration includetablets, lozenges and pastilles, wherein the active ingredient isformulated with a carrier such as sugar and acacia, tragacanth orgelatin and glycerin.

Compositions for rectal administration include suppositories containinga conventional suppository base such as cocoa butter.

Compositions suitable for transdermal administration include ointments,gels and patches.

Other compositions known to those skilled in the art can also be appliedfor percutaneous or subcutaneous administration, such as plasters.

Further, in preparing such pharmaceutical compositions comprising theactive ingredient or ingredients in admixture with components necessaryfor the formulation of the compositions, other conventionalpharmacologically acceptable additives may be incorporated, for example,excipients, stabilizers, antiseptics, wetting agents, emulsifyingagents, lubricants, sweetening agents, coloring agents, flavoringagents, isotonicity-agents, buffering agents, antioxidants and the like.As the additives, there may be mentioned, for example, starch, sucrose,fructose, dextrose, lactose, glucose, mannitol, sorbitol, precipitatedcalcium carbonate, crystalline cellulose, carboxymethylcellulose,dextrin, gelatin, acacia, EDTA, magnesium stearate, talc,hydroxypropylmethylcellulose, sodium metabisulfite, and the like.

In some embodiments, the composition is provided in a unit dosage formsuch as a tablet or capsule.

In further embodiments, the present invention provides kits includingone or more containers comprising pharmaceutical dosage units comprisingan effective amount of one or more compounds of the present invention.

The present invention further provides prodrugs comprising the compoundsdescribed herein. The term “prodrug” is intended to mean a compound thatis converted under physiological conditions or by solvolysis ormetabolically to a specified compound that is pharmaceutically active.The “prodrug” can be a compound of the present invention that has beenchemically derivatized such that, (i) it retains some, all or none ofthe bioactivity of its parent drug compound, and (ii) it is metabolizedin a subject to yield the parent drug compound. The prodrug of thepresent invention may also be a “partial prodrug” in that the compoundhas been chemically derivatized such that, (i) it retains some, all ornone of the bioactivity of its parent drug compound, and (ii) it ismetabolized in a subject to yield a biologically active derivative ofthe compound. Known techniques for derivatizing compounds to provideprodrugs can be employed. Such methods may utilize formation of ahydrolyzable coupling to the compound.

The present invention further provides that the compounds of the presentinvention may be administered in combination with a therapeutic agentused to prevent and/or treat metabolic and/or endocrine disorders,gastrointestinal disorders, cardiovascular disorders, obesity andobesity-associated disorders, central nervous system disorders, geneticdisorders, hyperproliferative disorders and inflammatory disorders.Exemplary agents include analgesics (including opioid analgesics),anesthetics, antifungals, antibiotics, antiinflammatories (includingnonsteroidal anti-inflammatory agents), anthelmintics, antiemetics,antihistamines, antihypertensives, antipsychotics, antiarthritic,antitussives, antivirals, cardioactive drugs, cathartics,chemotherapeutic agents (such as DNA-interactive agents,antimetabolites, tubulin-interactive agents, hormonal agents, and agentssuch as asparaginase or hydroxyurea), corticoids (steroids),antidepressants, depressants, diuretics, hypnotics, minerals,nutritional supplements, parasympathomimetics, hormones (such ascorticotrophin releasing hormone, adrenocorticotropin, growth hormonereleasing hormone, growth hormone, thyrptropin-releasing hormone andthyroid stimulating hormone), sedatives, sulfonamides, stimulants,sympathoinimetics, tranquilizers, vasoconstrictors, vasodilators,vitamins and xanthine derivatives.

Subjects suitable to be treated according to the present inventioninclude, but are not limited to, avian and mammalian subjects, and arepreferably mammalian. Mammals of the present invention include, but arenot limited to, canines, felines, bovines, caprines, equines, ovines,porcines, rodents (e.g. rats and mice), lagomorphs, primates, humans,and the like, and mammals in utero. Any mammalian subject in need ofbeing treated according to the present invention is suitable. Humansubjects are preferred. Human subjects of both genders and at any stageof development (i.e., neonate, infant, juvenile, adolescent, adult) canbe treated according to the present invention.

Illustrative avians according to the present invention include chickens,ducks, turkeys, geese, quail, pheasant, ratites (e.g., ostrich) anddomesticated birds (e.g., parrots and canaries), and birds in ovo.

The present invention is primarily concerned with the treatment of humansubjects, but the invention can also be carried out on animal subjects,particularly mammalian subjects such as mice, rats, dogs, cats,livestock and horses for veterinary purposes, and for drug screening anddrug development purposes.

In therapeutic use for treatment of conditions in mammals (i.e. humansor animals) for which a modulator, such as an agonist, of the ghrelinreceptor is effective, the compounds of the present invention or anappropriate pharmaceutical composition thereof may be administered in aneffective amount. Since the activity of the compounds and the degree ofthe therapeutic effect vary, the actual dosage administered will bedetermined based upon generally recognized factors such as age,condition of the subject, route of delivery and body weight of thesubject. The dosage can be from about 0.1 to about 100 mg/kg,administered orally 1-4 times per day. In addition, compounds can beadministered by injection at approximately 0.01-20 mg/kg per dose, withadministration 1-4 times per day. Treatment could continue for weeks,months or longer. Determination of optimal dosages for a particularsituation is within the capabilities of those skilled in the art.

5. Methods of Use

The compounds of formula I, II and/or III of the present invention canbe used for the prevention and treatment of a range of medicalconditions including, but not limited to, metabolic and/or endocrinedisorders, gastrointestinal disorders, cardiovascular disorders, obesityand obesity-associated disorders, central nervous system disorders,genetic disorders, hyperproliferative disorders, inflammatory disordersand combinations thereof where the disorder may be the result ofmultiple underlying maladies. In particular embodiments, the disease ordisorder is irritable bowel syndrome (IBS), non-ulcer dyspepsia, Crohn'sdisease, gastroesophogeal reflux disorders, constipation, ulcerativecolitis, pancreatitis, infantile hypertrophic pyloric stenosis,carcinoid syndrome, malabsorption syndrome, diarrhea, diabetes includingdiabetes mellitus (type II diabetes), obesity, atrophic colitis,gastritis, gastric stasis, gastrointestinal dumping syndrome,postgastroenterectomy syndrome, celiac disease, an eating disorder orobesity. In other embodiments, the disease or disorder is congestiveheart failure, ischemic heart disease or chronic heart disease. In stillother embodiments, the disease or disorder is osteoporosis and/orfrailty, congestive heart failure, accelerating bone fracture repair,metabolic syndrome, attenuating protein catabolic response, cachexia,protein loss, impaired or risk of impaired wound healing, impaired orrisk of impaired recovery from burns, impaired or risk of impairedrecovery from surgery, impaired or risk of impaired muscle strength,impaired or risk of impaired mobility, altered or risk of altered skinthickness, impaired or risk of impaired metabolic homeostasis orimpaired or risk of impaired renal homeostasis. In other embodiments,the disease or disorder involves facilitating neonatal development,stimulating growth hormone release in humans, maintenance of musclestrength and function in humans, reversal or prevention of frailty inhumans, prevention of catabolic side effects of glucocorticoids,treatment of osteoporosis, stimulation and increase in muscle mass andmuscle strength, stimulation of the immune system, acceleration of woundhealing, acceleration of bone fracture repair, treatment of renalfailure or insufficiency resulting in growth retardation, treatment ofshort stature, treatment of obesity and growth retardation, acceleratingthe recovery and reducing hospitalization of burn patients, treatment ofintrauterine growth retardation, treatment of skeletal dysplasia,treatment of hypercortisolism, treatment of Cushing's syndrome,induction of pulsatile growth hormone release, replacement of growthhormone in stressed patients, treatment of osteochondrodysplasias,treatment of Noonans syndrome, treatment of schizophrenia, treatment ofdepression, treatment of Alzheimer's disease, treatment of emesis,treatment of memory loss, treatment of reproduction disorders, treatmentof delayed wound healing, treatment of psychosocial deprivation,treatment of pulmonary dysfunction, treatment of ventilator dependency;attenuation of protein catabolic response, reducing cachexia and proteinloss, treatment of hyperinsulinemia, adjuvant treatment for ovulationinduction, stimulation of thymic development, prevention of thymicfunction decline, treatment of immunosuppressed patients, improvement inmuscle mobility, maintenance of skin thickness, metabolic homeostasis,renal homeostasis, stimulation of osteoblasts, stimulation of boneremodeling, stimulation of cartilage growth, stimulation of the immunesystem in companion animals, treatment of disorders of aging incompanion animals, growth promotion in livestock, and/or stimulation ofwool growth in sheep.

According to a further aspect of the invention, there is provided amethod for the treatment of post-operative ileus, cachexia (wastingsyndrome), such as that caused by cancer, AIDS, cardiac disease andrenal disease, gastroparesis, such as that resulting from type I or typeII diabetes, other gastrointestinal disorders, growth hormonedeficiency, bone loss, and other age-related disorders in a human oranimal patient suffering therefrom, which method comprises administeringto said patient an effective amount of at least one member selected fromthe compounds disclosed herein having the ability to modulate theghrelin receptor. Other diseases and disorders treated by the compoundsdisclosed herein include short bowel syndrome, gastrointestinal dumpingsyndrome, postgastroenterectomy syndrome, celiac disease, andhyperproliferative disorders such as tumors, cancers, and neoplasticdisorders, as well as premalignant and non-neoplastic or non-malignanthyperproliferative disorders. In particular, tumors, cancers, andneoplastic tissue that can be treated by the present invention include,but are not limited to, malignant disorders such as breast cancers,osteosarcomas, angiosarcomas, fibrosarcomas and other sarcomas,leukemias, lymphomas, sinus tumors, ovarian, uretal, bladder, prostateand other genitourinary cancers, colon, esophageal and stomach cancersand other gastrointestinal cancers, lung cancers, myelomas, pancreaticcancers, liver cancers, kidney cancers, endocrine cancers, skin cancersand brain or central and peripheral nervous (CNS) system tumors,malignant or benign, including gliomas and neuroblastomas.

In particular embodiments, the macrocyclic compounds of the presentinvention can be used to treat post-operative ileus. In otherembodiments, the compounds of the present invention can be used to treatgastroparesis. In still other embodiments, the compounds of the presentinvention can be used to treat diabetic gastroparesis. In anotherembodiment, the compounds of the present invention can be used to treatopioid-induced bowel dysfunction. In further embodiments, the compoundsof the present invention can be used to treat chronic intestinal pseudoobstruction.

The present invention further provides methods of treating a horse orcanine for a gastrointestinal disorder comprising administering atherapeutically effective amount of a modulator having the structure offormula I, II and/or III. In some embodiments, the gastrointestinaldisorder is ileus or colic.

As used herein, “treatment” is not necessarily meant to imply cure orcomplete abolition of the disorder or symptoms associated therewith.

The compounds of the present invention can further be utilized for thepreparation of a medicament for the treatment of a range of medicalconditions including, but not limited to, metabolic and/or endocrinedisorders, gastrointestinal disorders, cardiovascular disorders, obesityand obesity-associated disorders, genetic disorders, hyperproliferativedisorders and inflammatory disorders.

Further embodiments of the present invention will now be described withreference to the following examples. It should be appreciated that theseexamples are for the purposes of illustrating embodiments of the presentinvention, and do not limit the scope of the invention.

Example 1 Synthesis of Tethers

A. Standard Procedure for the Synthesis of Tether T9

Step T9-1: To a solution of 2-iodophenol (T9-0, 200 g, 0.91 mol, 1.0 eq)in DMF (DriSolv®, 560 mL) is added sodium hydride 60% in mineral oil(3.64 g, 0.091 mol, 0.1 eq) by portions (hydrogen is seen to evolve).The reaction is heated for 1 h at 100° C. under nitrogen, then ethylenecarbonate is added and the reaction mixture heated O/N at 100° C. Thereaction is monitored by TLC (conditions: 25/75 EtOAc/hex; R_(f): 0.15,detection: UV, CMA). The reaction mixture is allowed to cool, then thesolvent evaporated under reduced pressure. The residual oil is dilutedin Et₂O (1.5 L), then washed sequentially with 1 N sodium hydroxide (3×)and brine (2×), dried with MgSO₄, filtered and the filtrate evaporatedunder reduced pressure. The crude product is distilled under vacuum (200μm Hg) at 110-115° C. to provide T9-1.Step T9-2: A solution of T9-1 (45.1 g, 0.171 mol, 1.0 eq) andDdz-propargylamine (synthesized by standard protection procedures, 59.3g, 0.214 mol, 1.25 eq) in acetonitrile (DriSolv®, 257 mL) was degassedby passing argon through the solution for 10-15 min. To this was addedEt₃N (85.5 mL, stirred O/N with CaH₂, then distilled) and the mixturewas again purged by bubbling with argon, this time for 5 min.Recrystallized copper (I) iodide (1.14 g, 0.006 mol, 0.035 eq) andtrans-dichloro-bis(triphenylphosphine) palladium (II) (Strem Chemicals,3.6 g, 0.0051 mol, 0.03 eq) are added and the reaction mixture stirredfor 4 h under argon at rt. After 5-10 min, the reaction mixture turnedblack. The reaction was monitored by TLC (conditions: 55/45 EtOAc/hex).When complete, the solvent was removed under reduced pressure untildryness, then the residual oil diluted with 1 L of a 15% DCM in Et₂Osolution. The organic phase is washed with citrate buffer pH 4-5 (3×),saturated aqueous sodium bicarbonate (2×), and brine (1×), then driedwith MgSO₄, filtered and the filtrate evaporated under reduced pressure.The crude product thus obtained is purified by a dry pack columnstarting with 30% EtOAc/Hex (4-8 L) then increasing by 5% EtOAcincrements until 55% EtOAc/Hex to give T9-2 as a brown syrup (yield:65.8 g, 93.2%).Step T9-3: To a solution of Ddz-amino-alcohol T9-2 (65.8 g, 0.159 mol,1.0 eq) in 95% ethanol under nitrogen was added platinum (IV) oxide (3.6g, 0.016 mol, 0.1 eq) and then hydrogen gas bubbled into the solutionfor 2 h. The mixture was stirred O/N, maintaining an atmosphere ofhydrogen using a balloon. The reaction was monitored by ¹H NMR untilcompletion. When the reaction is complete, nitrogen was bubbled for 10min to remove the excess hydrogen. The solvent is evaporated underreduced pressure, then diluted with EtOAc, filtered through a silica gelpad and the silica washed with EtOAc until no further material waseluted as verified by TLC. (55/45 EtOAc/hex) The combined filtrates wereconcentrated under reduced pressure. The residue is diluted in DCM (500mL) and 4 eq of scavenger resin was added and the suspension stirredO/N. For this latter step, any of three different resins were used.MP-TMT resin (Argonaut Technologies, Foster City, Calif., 0.73 mmol/g)is preferred, but others, for example, PS-TRIS (4.1 mmol/g) andSi-Triamine (Silicycle, Quebec City, QC, 1.21 mmol/g) can also beemployed effectively. The resin was filtered and washed with DCM, thesolvent evaporated under reduced pressure, then dried further undervacuum (oil pump) to provide the product. The yield of Ddz-T9 from T9-0on a 65 g scale was 60.9 g (91%)

¹H NMR (CDCl₃): δ 7.19-7.01, (m, 2H), 6.92-9.83 (m, 2H), 6.53 (bs, 2H),6.34 (t, 1H), 5.17 (bt, 1H), 4.08 (m, 2H), 3.98 (m, 2H), 3.79 (s, 6H),3.01 (bq, 2H), 2.66 (t, 3H), 1.26 (bs, 8H);

¹³C NMR (CDCl₃): 6160.9, 156.8, 155.6, 149.6, 130.4, 127.5, 121.2,111.7, 103.2, 98.4, 80.0, 69.7, 61.6, 55.5, 40.3, 30.5, 29.3, 27.4 ppm.

Tether T9 can also be synthesized from another tether molecule byreduction as in step T9-3 or with other appropriate hydrogenationcatalysts known to those in the art.

B. Standard Procedure for the Synthesis of Tether T33a and T33b

The construction to the (R)-isomer of this tether (T33a) wasaccomplished from 2-iodophenol (33-0) and (S)-methyl lactate (33-A).Mitsunobu reaction of 33-0 and 33-A proceeded with inversion ofconfiguration in excellent yield to give 33-1. Reduction of the ester tothe corresponding alcohol (33-2) also occurred in high yield and wasfollowed by Sonagashira reaction with Ddz-propargylamine. The alkyne inthe resulting coupling product, 33-3, was reduced with catalytichydrogenation. Workup with scavenger resin provided the desired product,Ddz-T33a.

The synthesis of the (S)-enantiomer (Ddz-T33b) was carried out in anidentical manner in comparable yield starting from (R)-methyl lactate(33-B)

C. Standard Procedure for the Synthesis of Tether Precursor RCM-T_(A1)

Step A1-1. To a solution of diol A1-0 (50 g, 567 mmol, 1.0 eq) in CH₂Cl₂(1.5 L) were added Et₃N (34.5 mL, 341 mmol, 0.6 eq) and DMAP (1.73 g,14.2 mmol, 0.025 eq). TBDMSCl (42.8 g, 284 mmol, 0.5 eq) in CH₂Cl₂ (100mL) was added to this mixture at rt over 4 h with a syringe pump. Thereaction was monitored by TLC [EtOAc/hexanes (30:70); detection: KMnO₄;R_(f)=0.39], which revealed starting material, mono-protected compoundand di-protected compound. The mixture was stirred O/N, washed with H₂O,saturated NH₄Cl (aq) and brine, then dried over MgSO₄, filtered andevaporated under reduced pressure. The residue was purified by flashchromatography (EtOAc/hexanes, 30:70) to give the desired mono-protectedalcohol A1-1 (yield: 31%).Step A1-2. To a solution of alcohol A1-1 (26.5 g, 131 mmol, 1.0 eq) inTHF (130 mL) at 0° C. was added PPh₃ (44.7 g, 170 mmol, 1.3 eq). Afreshly prepared and titrated 1.3 M solution of HN₃ (149 mL, 157 mmol,1.5 eq) was added slowly to this mixture, then DIAD (32 mL, 163 mmol,1.25 eq) also added slowly. This was an exotheric reaction. Theresulting mixture was stirred at 0° C. for 1 h with monitoring of thereaction by TLC [EtOAc/hexanes (30:70); detection: KMnO₄; R_(f)=0.77].Compound A1-2 was obtained, but was not isolated and instead useddirectly for the next step in solution.Step A1-3. PPh₃ (51 g, 196 mmol, 1.5 eq) was added by portion to thesolution of A1-2 and the resulting mixture was stirred at 0° C. for 2 h,allowed to warm to rt and maintained there for 3 h, then H₂O (24 mL,1331 mmol, 10 eq) added. This mixture was heated at 60° C. O/N. Thereaction was monitored by TLC [EtOAc/hexanes (1:9); detection: KMnO₄;R_(f)=baseline]. After cooling, a solution of 2 N HCl (327 mL, 655 mmol,5.0 eq) was added and the resulting mixture stirred at rt for 2 h toobtain compound A1-3 in solution, which was used directly in the nextstep. TLC [DCM/MeOH/30% NH₄OH (7:3:1); detection: KMnO₄; R_(f)=0.32].Step A1-4. For the next transformation, THF was evaporated under reducedpressure from the above reaction mixture and the remaining aqueous phaseextracted with Et₂O (5×150 mL) and CHCl₃ (3×150 mL). The organic phaseswere monitored by TLC and if any A1-3 was observed, the organic phasewas then extracted with 2 N HCl. The aqueous phase was neutralizedcautiously to pH 8 with 10 N NaOH. CH₃CN (400 mL) was added to thisaqueous solution and Fmoc-OSu (41.9 g, 124 mmol, 0.95 eq) in CH₃CN (400mL) added slowly over 50 min. The solution was stirred at rt O/N. Thereaction progress was monitored by TLC [EtOAc/hexanes (1:1); detection:ninhydrin; R_(f)=0.27]. The aqueous phase was extracted with Et₂O, thenthe combined organic phase dried over MgSO₄ and concentrated underreduced pressure. The solid residue obtained was mixed with H₂O (120mL), stirred 30 min, filtered (to remove succinimide byproduct) anddried O/N under vacuum (oil pump). The solid was purified by flashchromatography [gradient: EtOAc/hexanes (50:50) to EtOAc/hexanes(70:30), with the change of eluent once Fmoc-OSu was removed asindicated by TLC] to give compound T_(A1) as a white solid (yield: 71%).

¹H NMR (CDCl₃, ppm): 7.8 (d, 2H), 7.6 (d, 2H), 7.4 (t, 2H), 7.3 (t, 2H),5.9-5.7 (1H, m), 5.6-5.5 (1H, m), 5.0 (1H, broad), 4.4 (2H, d), 4.2 (2H,d), 3.9 (2H, broad), 2.1 (1H, broad).

¹³C NMR (CDCl₃, ppm): 156.8, 144.1, 141.5, 131.9, 128.3, 127.9, 127.3,125.2, 120.2, 67.0, 58.0, 47.4, 38.0.

D. Standard Procedure for the Synthesis of Tether Precursor RCM-T_(A2)

This material was accessed through application of the cross metathesisreaction shown to construct the carbon backbone. The resulting nitrilewas reduced to the amine, which was protected in situ with Fmoc or otherappropriate protecting group prior to attachment to the resin, which wasperformed using standard solid phase chemistry procedures known to thosein the art. This standard procedure would also be applicable tohomologues of T_(A2).E. Standard Procedure for the Synthesis of Tether Precursor RCM-T_(B1)

Step B1-1. To 2-bromobenzyl alcohol (B1-0, 30 g, 160 mmol) in DCM(DriSolv®, 530 mL) as an approximately 0.3 M solution, was addeddihydropyran (B1-A, 22 mL, 241 mmol). Pyridinium p-toluenesulfonate(PPTS, 4.0 g, 16 mmol) was added and the reaction mixture stirredvigorously at rt O/N. A saturated solution of Na₂CO₃ (aq, 200 mL) wasthen added and the mixture stirred for 30 min. The DCM layer wasseparated, washed successively with saturated Na₂CO₃ (aq, 2×100 mL) andbrine (2×50 mL), and dried over anhydrous MgSO₄. The solvent wasevaporated under reduced pressure and the crude residue was purified bydry-pack silica-gel column. [EtOAc/hexanes (1:9); before loading thecrude material, the silica was neutralized by flushing with 1% Et₃N inDCM] This afforded B1-1 as a colorless oil (42 g, 97%). TLC[EtOAc/hexanes (1:9); R_(f)=0.56]Step B1-2. Magnesium turnings (2.21 g, 90 mmol) were added to anapproximately 0.8 M solution of B1-1 (from which several portions oftoluene were evaporated to remove traces of water, 22.14 g, 81.8 mmol)in anhydrous THF (distilled from sodium benzopheneone ketyl, 100 mL)under an atmosphere of nitrogen. The reaction was initiated by addingiodine chips (50 mg, 0.002 equiv). The reaction mixture was heated toreflux for 2 h, during which time most of the Mg turnings disappeared.The reaction was allowed to cool to rt. In a separate flame-driedround-bottomed flask, freshly distilled allyl bromide (6.92 mL, 81.8mmol) was diluted with anhydrous THF (50 mL) under a nitrogen atmosphereand cooled to 0° C. using an ice-water bath. To this was graduallytransferred the now cooled Grignard solution over a period of 20-30 minusing a cannula ensuring that the unreacted magnesium turnings remainedin the source flask. The contents of the Grignard preparation flask werewashed (2×5 mL dry THF) and the washings transferred via cannula to theallyl bromide solution as well. The resulting mixture was stirred O/Nunder N₂ while allowing it to gradually warm to rt. The reaction wasquenched by adding saturated NH₄Cl (aq) solution, then diluted with 100mL Et₂O and the layers separated. The aqueous phase was extracted withEt₂O (3×100 mL) and the combined organic layers dried over MgSO₄, thenconcentrated under reduced pressure to provide B1-2 (18.54 g, 98%). TLC[EtOAc/hexanes (1:9), R_(f)=0.53]. This material was utilized in thenext step without further purification.Step B1-3. 2-(2-Propenyl)benzyl alcohol (T_(B1)). The crude THP etherB1-2 (18.54 g, 80 mmol) was dissolved in MeOH (160 mL) andp-toluenesulfonic acid monohydrate (PTSA, 1.52 g, 8 mmol) added. Theresulting mixture was stirred at rt O/N, then concentrated under reducedpressure and the residue diluted with Et₂O (100 mL). The organic layerwas sequentially washed with 5% NaHCO₃ (aq) solution (3×50 mL) and brine(1×50 mL), then dried over MgSO₄. The solvent was evaporated underreduced pressure and the residue purified by flash chromatography(EtOAc/hexanes, 1:9), to obtain T_(B1) as a pale-yellow oil (9.2 g,78%). TLC [EtOAc/hexanes (1:9), detection: UV, PMA; R_(f)=0.24].F. Standard Procedure for the Synthesis of Tether Precursor RCM-T_(B2)

Step B2-1. To a suspension of MePPh₃Br (85.7 g, 240 mmol, 2.2 eq) in THF(500 mL) was added t-BuOK in portions (26.9 g, 240 mmol, 2.2 eq) and theresulting mixture stirred at rt for 2 h during which time it becameyellow. The reaction mixture was cooled to −78° C.,2-hydroxybenzaldehyde (B2-0, 11.6 mL, 109 mmol, 1.0 eq) added over 10min, then it was stirred O/N at rt. The reaction progress was monitoredby TLC [EtOAc/hexanes (20:80); detection: UV, CMA; R_(f)=0.25]. Asaturated NH₄Cl (aq) solution was added and the resulting aqueous phaseextracted with Et₂O (3×). The combined organic phase was dried overMgSO₄, filtered and concentrated under reduced pressure. The residue waspurified by flash chromatography (EtOAc/hexanes, 30:70) to give B2-1 asa yellow oil. The identity and purity were confirmed by ¹H NMR (yield:1100%).Step B2-2. To a solution of alcohol B2-1 (2.0 g, 16.7=mmol, 1.0 eq) inDMF at 0° C. was added cesium carbonate (1.1 g, 3.34 mmol, 0.2 eq) andthe mixture stirred at 0° C. for 15 min. The reaction was warmed to 100°C. and ethylene carbonate added. The resulting mixture was stirred at100° C. O/N. The reaction was monitored by TLC [EtOAc/hexanes (30:70);detection: LUV, CMA; R_(f) 0.21]. The solution was cooled to rt and H₂Oadded. The resulting aqueous phase was extracted with Et₂O (3×). Theorganic phase was extracted with brine (3×), dried with MgSO₄, filteredand concentrated under reduced pressure. A yellow syrup (T_(B2)) wasobtained (yield: 96%), which was of sufficient purity (as assessed byNMR) for further use without additional purification. Note that thisproduct proved to be unstable in the presence of acid.

¹H NMR (CDCl₃, ppm): 7.50 (1H, dd, Ph), 7.22 (1H, td, Ph), 7.05 (dd, 1H,PhCH═CH₂), 6.98 (1H, t, Ph), 7.90 (1H, d, Ph), 5.75 (1H, dd, PhCH═CHH),5.30 (1H, dd, PhCH—CHH), 4.15-4.10 (2H, m, PhOCH ₂CH₂OH), 4.05-3.95 (2H,m, PhOCH₂CH ₂OH), 2.05 (1H, s, OH).

G. Standard Procedure for the Synthesis of Tether Precursor RCM-T_(B3)

To a solution of 2′-bromophenethylalcohol (B3-0, 2.0 mL, 14.9 mmol, 1.0eq) in toluene (50 μL) were addedtetrakis(triphenylphosphine)palladium(0) [Pd(PPh₃)₄, 347 mg, 0.30 mmol,0.02 eq) and vinyltributyltin (6.5 mL, 22.4=mol, 1.5 eq). The resultingmixture was stirred at reflux for 24 h under N₂. Monitoring reactionprogress by TLC was difficult since the starting material and productpossessed the same R_(f) [EtOAc/hexanes (30:70)]. The reaction mixturewas cooled to rt and saturated KF (aq) solution added at which time aprecipitate was formed. The solid was optionally removed by filtrationand the aqueous phase extracted with DCM (4×). The combined organicphase was extracted with brine, dried over MgSO₄ and concentrated underreduced pressure. The residue was purified by flash chromatography(EtOAc/hexanes, 30:70) to give T_(B3) as a colorless oil. The identityand purity were confirmed by ¹H NMR (yield: 100%).

¹H NMR (CDCl₃, ppm): 7.57-7.45 (1H, m, Ph), 7.30-7.15 (3H, m, Ph), 7.05(dd, 1H, PhCH—CH₂), 5.65 (1H, dd, PhCH═CHH), 5.32 (1H, dd, PhCH═CHH),4.85 (2H, t, PhCH₂CH ₂OH), 2.98 (2H, t, PhCH ₂CH₂OH), 1.50 (1H, s, OH).

H. Standard Procedure for the Synthesis of Tether Precursor RCM-T_(B4)

Step B4-1. 1,2-Dihydronaphthalene (B4-0, 5.0 g, 38.4 mmol, 1.0 eq) wasdissolved in 200 mL of DCM:MeOH (1:1) and the solution cooled to −78° C.Ozone (O₃) was bubbled through the solution until a blue colordeveloped. The reaction was monitored by TLC [EtOAc/hexanes (30:70);detection: UV, CMA; R_(f)=0.25]. Excess O₃ was then removed by bubblingN₂ through the solution until the blue color had dissipated. Sodiumborohydride (2.9 g, 76.8 mmol, 2.0 eq) was added slowly to the mixture,then it was stirred at rt for 1 h. The reaction was monitored by TLC[EtOAc/hexanes (30:70); detection: UV, CMA; R_(f)=0.06]. A saturatedNH₄Cl (aq) solution was added slowly, then the aqueous phase wasextracted with DCM (3×). The combined organic phase was dried overMgSO₄, filtered and concentrated under reduced pressure. B4-1 wasobtained as a yellow oil (yield: 100%). The identity and purity of thecompound was confirmed by NMR analysis and typically was of sufficientpurity to be used without further manipulation.Step B4-2. To a solution of the diol B4-1 (6.38 g, 38.4 mmol, 1.0 eq) inbenzene (200 HL) was added MnO₂ (85%, 16.7 g, 192 mmol, 5.0 eq) and theresulting mixture stirred 1 h at rt. The reaction was monitored by TLC[EtOAc/hexanes (50:50); detection: UV, CMA; R_(f)=0.24] and more MnO₂ (5eq) added each 1 h period until the reaction was completed, typicallythis required 2-3 such additions. The MnO₂ was filtered through a Celitepad, which was then washed with EtOAc. The combined filtrate and washeswere evaporated under reduced pressure to give B4-2. A ¹H NMR was takento check the purity of the resulting compound, which typically containedsmall amounts of impurities. However, this was sufficiently pure for usein the next step, which was preferably performed on the same day as thisstep since the aldehyde product (B4-2) had limited stability.Step B4-3. To a suspension of MePPh₃Br (30.2 g, 84.5 mmol, 2.2 eq) inTHF (200 mL) was added t-BuOK in portions (9.5 g, 84.5 mmol, 2.2 eq) andthe resulting mixture stirred at rt for 2 h during which time thesolution became yellow. The reaction mixture was cooled to −78° C., B4-2[6.3 g, 38.4 mmol, 1.0 eq (based on the theoretical yield)] added over10 min, then the mixture stirred O/N at rt. The reaction was monitoredby TLC [EtOAc/hexanes (50:50); detection: UV, CMA; R_(f)=0.33]. Asaturated NH₄Cl (aq) solution was added and the resulting aqueous phaseextracted with EtOAc (3×). The combined organic phase was dried overMgSO₄, filtered and concentrated under reduced pressure. The residue waspurified by flash chromatography (EtOAc/hexanes, 40:60) to give T_(B4)as a yellow oil. NMR was used to confirm the identity and purity of theproduct (yield: 73%, 2 steps).

¹H NMR (CDCl₃, ppm): 7.55-7.45 (1H, m, Ph), 7.25-7.10 (3H, m, Ph), 7.05(dd, 1H, PhCH═CH₂), 5.65 (1H, dd, PhCH═CHH), 5.30 (1H, dd, PhCH═CHH),3.70 (2H, t, PhCH₂CH₂CH ₂OH), 2.80 (2H, t, PhCH ₂CH₂CH₂OH), 1.90-1.80(2H, m, PhCH₂CH ₂CH₂OH), 1.45 (1H, s, OH).

I. Standard Procedure for the Synthesis of Tether T45

The protected version of this tether was obtained through standardtransformations involving monoprotection of triethyleneglycol (45-0)followed by conversion of the remaining alcohol to a mesylate,displacement with azide and catalytic reduction in the presence ofdi-t-butyl dicarbonate.

J. Standard Procedure for the Synthesis of Tether T65

See the preparation of T9-2 as this tether is actually an intermediatein the synthesis of tether T9.

¹H NMR (CDCl₃): δ 7.38-7.35 (bd, 1H), 7.30-7.19 (m, 1H), 6.92 (dd, 2H),4.88 (bs, 1H), 4.16-4.11 (bt, 4H), 3.98-3.95 (t, 2H), 1.46 (s, 9H).

¹³C NMR (CDCl₃): δ 156.7, 155.8, 133.6, 130.0, 121.3, 114.8, 113.1,112.9, 90.2, 70.8, 61.4, 28.6

K. Standard Procedure for the Synthesis of Tether T66

To a solution of alkyne (Boc-T65, 13.1 g, 45.1 mmol, 1.0 eq) inEtOH/AcOEt (5:1) under N₂ is added quinoline (106 μl, 0.9 mmol, 0.02 eq)and the Lindlar catalyst (1.3 g, 10% wt), then hydrogen is bubbled intothe mixture. The reaction is monitored (each 30-40 min) by ¹H NMR untilthe reaction is complete. Then, the reaction is filtered through aCelite pad and rinsed with AcOEt until there is no more materialeluting. The solvent is removed under reduced pressure. The crudeproduct is purified by flash chromatography with 15% AcOEt/Hex to 40%AcOEt/Hex to give Boc-T66 an oil. (Yield: 7.8 g, 59%) TLC (45/55AcOEt/Hex): R_(f): 0.15; detection: UV, KMnO₄.

¹H NMR (CDCl₃): δ 7.27-7.21 (td, 1H), 7.15-7.10 (dd, 1H), 7.00.6.85, (m,2H), 6.62-6.58 (bd, 1H), 5.77-5.70 (dt, 1H), 4.13-4.03 (m, 2H),3.97-3.95 (m, 2H), 3.9-3.88 (bd, 2H), 1.46, (s, 9H)

L. Standard Procedure for the Synthesis of Tether T67

To a solution of Et₂Zn (1 M in hexanes, 153 mL, 153.6 mmol, 3.0 eq) inCH₂Cl₂ (150 mL) at −20° C. was added CH₂I₂ (12.4 mL, 153.6 mmol, 3.0 eq)(CAUTION: Pressure can develop.) and the mixture stirred at −20° C. for15 min. Boc-T8 (15.0 g, 51.2 mmol, 1.0 eq) in CH₂Cl₂ (100 mL) was thenadded and the mixture stirred at room temperature O/N. The reaction wasmonitored by TLC [(60% AcOEt: 40% hexane); detection: UV and CMA;R_(f)=0.39]. The solution was treated with aqueous NH₄Cl (saturated) andthe aqueous phase was extracted with CH₂Cl₂. The organic phase was driedover MgSO₄ and concentrated under reduced pressure. The residue waspurified by flash chromatography (60% AcOEt: 40% hexane) to give Boc-T67as a yellow oil (yield: 57%).

¹H NMR (CDCl₃, ppm): 7.18 (1H, t), 7.03 (1H, d), 6.88 (2H, t), 4.23-4.04(4H, m), 3.73-3.70 (2H, m), 1.48 (1H, broad), 1.28 (9H, s), 1.12-1.06(1H, m), 1.0-0.93 (1H, m), 0.76 (2H, dt).

M. Standard Procedure for the Synthesis of Tether T68

To a solution of Et₂Zn (1 M in hexanes, 49.2 mL, 49.2 mmol, 3.0 eq) inCH₂Cl₂ (30 mL) at −20° C. was added CH₂I₂ (3.9 mL, 49.2 mmol, 3.0 eq)and the mixture stirred at −20° C. for 15 min. The alkene (Boc-T66, 4.8g, 16.4 mmol, 1.0 eq) in CH₂Cl₂ (50 mL) was then slowly added and themixture stirred at room temperature for 2 h. The solution was treatedwith aqueous NH₄Cl (saturated) and the aqueous phase extracted withCH₂Cl₂ (1×) then washed with brine (1×). The organic phase was driedover MgSO₄, filtered and the solvent removed under reduced pressure. Thecrude product is purified by flash chromatography (gradient: 40%, then50% and finally 60% AcOEt in hexanes) to give Boc-T68 as a yellow oil(yield: 90.7%). TLC (60% AcOEt: 40% hexanes): R_(f): 0.4; detection: UV,ninhydrin.

¹H NMR (CDCl₃): δ 7.32-7.20 (td, 2H), 7.10-6.85, (m, 2H), 4.25-4.13 (m,2H), 4.10-3.99 (m, 2H), 3.41-3.36 (dd, 1H), 2.15-2.02 (m, 1H), 1.38 (s,9H), 1.04-0.96 (dq, 1H), 0.78-0.73 (q, 1H)

¹³C NMR (CDCl₃): δ 158.0, 130.7, 130.4, 127.9, 127.5, 127.1, 121.2,121.0, 111.6, 111.2, 79.5 69.8, 61.5, 28.7, 17.8, 16.8, 7.2

N. Standard Procedure for the Synthesis of Tether T69

TLC (25/75 AcOEt/Hex): R_(f): 0.03; detection: UV, ninhydrin

¹H NMR (CDCl₃): δ 7.06-7.00 (bt, 1H), 6.61-6.52 (m, 4H), 6.35 (m, 1H),5.12 (bt, 1H), 4.03 (m, 2H), 3.95 (m, 2H), 3.77 (s, 6H), 3.11-3.04 (bq,2H), 2.60 (bt 2H) 1.75 (m, 8H)

¹³C NMR (CDCl₃): δ 163.9, 160.9, 160.6, 157.6, 157.5, 155.6, 149.5,130.8, 130.6, 125.9, 107.26, 106.9, 103.2, 98.4, 80.8, 77.5, 69.9, 61.3,60.9, 60.6, 55.4, 40.3, 30.4, 29.3, 26.9,

LC-MS (Grad_A4) t_(R): 8.37 min

O. Standard Procedure for the Synthesis of Tether T70

TLC (25/75 AcOEt/Hex): R_(f). 0.03; detection: UV, ninhydrin

¹H NMR (CDCl₃): δ 6.84-6.75 (m, 3H), 6.52 (bs, 2H), 6.34 (m, 1H), 5.17(bt, 1H), 4.01 (m, 2H), 3.93 (m, 2H), 3.77 (s, 6H), 3.10 (bq, 2H), 2.63(bt, 2H), 1.74 (m, 8H)

¹³C NMR (CDCl₃): δ 160.9, 158.9, 155.8, 155.6, 152.9, 152.9, 149.5,132.4, 132.3, 1117.1, 116.8, 112.7, 112.6, 103.2, 98.4, 80.8, 70.4,61.6, 55.5, 40.2, 30.3, 29.3, 27.4.

LC-MS (Grad_A4) t_(R): 8.29 min

P. Standard Procedure for the Synthesis of Tether T71

TLC (25/75 AcOEt/Hex): Rf: 0.03; detection: UV, ninhydrin

¹H NMR (CDCl₃): δ 7.12-7.08 (bd, 2H), 6.76-6.73 (d, 1H), 6.52 (m, 2H),6.33 (bs, 1H), 5.15 (bt, 1H), 4.02 (m, 2H), 3.95 (m, 2H), 3.79 (s, 6H),3.09 (bq, 2H), 2.61 (bt, 2H), 1.74 (m, 8H)

¹³C NMR (CDCl₃): δ 160.8, 155.6, 155.4, 149.5, 132.4, 130.1, 127.0,126.0, 112.8, 103.2, 98.4, 80.8, 70.0, 61.4, 55.5, 40.3, 30.2, 29.3,24.5, 27.4

LC-MS (Grad_A4) t_(R): 9.60 min

Q. Standard Procedure for the Synthesis of Tether T72

TLC (1/1, Hex/AcOEt): R_(f): 0.16

¹H NMR (ppm): 1.49 (Boc), 1.8 (CH2), 2.7 (CH2), 3.1 (CH2), 4.0 (CH2),4.1 (CH2), 4.9 (NH), 6.9 (CH aromatic), 7.35 (CH aromatic), 7.4 (CHaromatic)

¹³C NMR (ppm): 29, 30, 40, 61, 70, 110, 124, 128, 132, 160

R. Standard Procedure for the Synthesis of Tether T73

TLC (60/40 AcOEt/Hex): R_(f): 0.11; detection: UV, ninhydrin,

¹H NMR (CDCl₃): δ 7.06-6.99, (m, 2H), 6.84-6.81 (m, 1H), 6.5 (m, 2H),6.32 (m, 1H), 5.11 (bt, 1H), 4.07 (m, 2H), 3.90 (bt, 2H), 3.79 (s, 6H),3.39 (s, 3H), 3.09 (bt, 2H), 2.64 (bt, 2H), 1.85-1.74 (m, 8H), 1.46 (bs,9H)

¹³C NMR (CDCl₃): δ 160.8, 157.1, 155.6, 151.9, 149.5, 131.3, 131.0,128.43, 128.37, 111.6, 103.2, 98.4, 84.8, 80.8, 69.9, 61.4, 60.6, 55.5,41.8, 40.2, 30.0, 29.3, 28.1, 27.3 ppm.

LC-MS (Grad_A4) t_(R): 8.26 min.

S. Standard Procedure for the Synthesis of Tether T74

TLC (50/50 AcOEt/Hex): R_(f): 0.09; Detection: UV, CMA

¹H NMR (DMSO-d₆): δ 7.14 (bd, 1H), 6.76-6.71 (m, 2H), 6.53 (m, 2H), 6.33(bs, 1H), 5.15 (bt, 1H), 4.08 (m, 2H), 3.95 (m, 2H, 3.79 (s, 6H), 3.41(s, 3H), 3.01 (bq, 2H), 2.64 (bt, 2H), 1.75 (m, 8H), 1.47 (s, 9H)

¹³C NMR (DMSO-d₆): δ 156.1, 152.3, 150.8, 147.0, 144.7, 129.8, 126.9,125.6, 116.8, 108.4, 98.5, 93.6, 80.3, 76.1, 65.1, 56.7, 50.7, 37.1,35.6, 25.3, 24.5, 23.4, 22.6

LC-MS (Grad_A4) t_(R): 8.21 min

T. Standard Procedure for the Synthesis of Tether T75a and T75b

The synthesis of the fluorinated derivative, tether T75, was carried outin an analogous matter to that of the related tether T33 starting from33-A [(S)-methyl lactate] and appropriately substituted phenol 75-0 toprovide 4.1 g of Ddz-T75a as a pale yellow solid. Although the first twosteps, Mitsunobu reaction and DIBAL reduction, were high yielding, 91%and 98% respectively, isolation of the final product proved difficultafter Sonagashira coupling and hydrogenation, lowering the overall yieldto 17%. Again, the corresponding (R)-enantiomer, Ddz-T75b, is accessibleby substituting (R)-methyl lactate (33-B) in the above procedure.

U. Standard Procedure for the Synthesis of Tether T76

Step T76-1. 3-Bromo-2-hydroxy-benzaldehyde. In a manner analogous tothat of the literature (Hofslokken et al. Acta. Chemica Scand. 1999, 53,258), a stirred suspension of 2-bromophenol (76-0, 3.5 g, 20 mmol) andparaformaldehyde (8.1 g, 270 mmol) in 100 mL of dry acetonitrile at roomtemperature was treated with MgCl₂ (2.85 g, 30 mmol) and triethylamine(TEA, 10.45 ml, 75 mmol). The mixture was stirred vigorously at refluxO/N. After this period of time, the mixture was cooled to roomtemperature, then 30 mL of 5% HCl was added and the product extractedwith Et₂O to give 4.0 g (95%) of 76-1.

TLC (hexanes/dichloromethane, 3:1): R_(f)=0.3; detection: CMA and UV

Step 76-2. 2-Bromo-6-vinyl-phenol. To a stirred solution of CH₃PPh₃Br(72 g, 0.033 mol) at room temperature was added, over 5 min, a solutionof tBuOK (4.1 g, 0.03 mol) in THF (50 mL). The mixture was cooled to−78° C. and 76-1 (3 g, 0.015 mol) was added dropwise over 15 min. Thereaction mixture was allowed to warm to room temperature and stirred for24 h. After this time, the solvent was removed in vacuo and the residuepurified by flash chromatography using hexanes/dichloromethane (3:1) aseluent to afford 76-2 as a colorless oil (2.2 g, 75%).

TLC (hexanes/dichloromethane, 3:1): R_(f)=0.5; detection: CMA and UV

Step 76-3. The tosylate 76-A was synthesized using the literature method(Buono et al. Eur. J. Org. Chem. 1999, 1671) and then utilized for 76-3(Manhas, M. S. J. Am. Chem. Soc. 1975, 97, 461-463. Nakano, J.Heterocycles 1983, 20, 1975-1978). To a solution of 76-2 (2.5 g, 12mmol), Ph₃P (4.6 g, 18 mmol) and 76-A (4.3 g, 18 mmol) in 150 mL of THFwas slowly added diethylazodicarboxylate (DEAD, 3.5 mL, 18 mmol) at roomtemperature. The mixture was stirred at room temperature for 6 h untilthe reaction was complete as indicated by TLC analysis (hexanes/ethylacetate, 8:2; R_(f)=0.6; detection: CMA and UV). The solvent was removedunder high vacuum and the residue was purified by flash chromatographyto obtain 76-3 as a pale brown liquid (4.6 g, 88%).Step 76-4. 76-3 (3.4 g, 8 mmol) was treated with second generationGrubbs catalyst (0.02 mol %) in 50 mL of DCM (Grubbs, R. J. Org. Chem.1998, 63, 864-866. Gross, J. Tet. Lett. 2003, 44, 8563-8565. Hoveyda, A.J. Am. Chem. Soc. 1998, 120, 2343-2351). The resulting mixture wasstirred at room temperature for 12 h The solvent was then removed underhigh vacuum and the residue purified by flash column chromatography toobtain 76-4 as a pale brown liquid (2.15 g, 70%). TLC (hexanes/ethylacetate, 8:2; R_(f) 0.4; detection: CMA and UV).Step 76-5. To a solution of 76-4 (1.43 g, 0.023 mol) in dry DMF (50 mL)was added cesium acetate (2.09 g, 0.0109 mol) under an argon atmosphere.The solution was stirred at 50° C., O/N. After this time, the solventwas removed under high vacuum and the residue purified by flashchromatography to obtain 76-5 as a pale brown liquid (0.7 g, 70%). TLC(hexanes/ethyl acetate, 8:2; R_(f)=0.6; detection: CMA and UV).Step 76-6 (8-Bromo-2H-chromen-2-yl)-methanol. To a solution of 76-5 (5.5g, 0.023 mol) in dry MeOH (150 mL) was added sodium metal in a catalyticamount under an argon atmosphere. The solution was then stirred at roomtemperature for 60 min. After this time, Amberlite IRA-120 (H⁺) resinwas added to neutralize (pH=7) excess sodium methoxide and the mixturewas vigorously stirred for 10 min. The resin was removed by filtrationand the filtrate evaporated in vacuo. Pure compound 76-6 was recoveredas a colorless oil (4.5 g, 98%).

TLC (hexanes/ethyl acetate, 7:3): R_(f)=0.3; detection: CMA and UV

Step 76-7. 76-6 (4.5 g, 18 mmol) and Ddz-propargyl amine (76-B, 15.16 g,55.8 mmol) were dissolved in dioxane (150 mL) and diisopropylamine (27mL). The reaction mixture was degassed by bubbling argon through thesolution. PdCl₂(PhCN)₂ (430 mg, 1.11 mmol, 0.06 eq), CuI (220 mg, 1.11mmol, 0.06 eq) and tributylphosphine (10% in hexane, 4.4 mL, 2.23 mmol)were added and the mixture was warmed to 70° C. and stirred O/N. Thesolvent was removed under high vacuum and the residue purified by flashcolumn chromatography to obtain 76-7 as a pale brown liquid (3.2 g,80%).

TLC (hexanes/ethyl acetate, 1:1): R_(f)=0.3; detection: CMA and UV

Step 76-8. The acetylene 76-7 (4.5 g, 0.2 mol) was dissolved in EtOH(150 mL), then purged with nitrogen for 10 min. PtO₂ (10 mol %, 450 mg)was added, and the mixture purged with a balloon full of hydrogen gas.The mixture was then charged into a Parr bomb, flushed with hydrogen(simply fill with hydrogen at 60 psi, then release and refill, repeatthis fill-release-refill cycle 3×), and reacted with hydrogen at 60 psiat room temperature O/N. The reaction mixture was filtered through a padof Celite (use methanol for washing the pad) and the filtrateconcentrated to afford a practically pure (clean by ¹H NMR), but coloredsample of Ddz-T76 in quantitative yield. Further purification wasachieved by subjecting this material to flash chromatography. TLC(hexanes/ethyl acetate, 1:1; R_(f)=0.3; detection: CMA and UV). Sincethe product Ddz-T76 has the same R_(f) as the starting material (76-7),¹H NMR is the best way to distinguish them.

¹H NMR (CDCl₃): δ 1.73 (s, 6H), 1.75-1.95 (m, 4H), 2.60 (m, 2H),2.70-2.90 (m, 2H), 3.10 (m, 2H), 3.72 (s, 6H), 3.75 (m, 2H), 4.12 (m,1H), 5.20 (m, 1H), 6.35 (s, 1H), 6.50 (s, 2H), 6.80 (m, 1H), 6.90 (m,2H).

¹³C NMR (CDCl₃): δ 23.93 (CH₂), 24.97 (CH₂), 27.07 (CH₂), 29.35 (CH₃),30.45 (CH₂), 40.23 (CH₂), 55.47 (CH₃), 65.76 (CH2), 80.72 (CH), 98.44(CH), 103.22 (CH), 120.29 (CH), 121.90 (Cq), 127.76 (CH), 128.14 (CH),129.42 (Cq), 149.56 (Cq), 152.55 (Cq), 155.56 (Cq), 160.84 (Cq).

LC-MS (Grad_A4): t_(R): 9.46 min; Mass found: 443

V. Standard Procedure for the Synthesis of Tether T77

Step T77-1. 3-Bromo-pyridin-2-ol. A stirred suspension of 2-pyridone(77-0, 19 g, 200 mmol) in 200 mL of 1 M aqueous KBr at room temperaturewas treated over 15 min with bromine (32 g, 200 mmol; CAUTION: Largequantities of Br₂ should be handled carefully!) in 200 mL of 1 M aqueousKBr, then stirred vigorously at room temperature O/N. After 24 h, thissolution deposited crystals which were filtered off and thenrecrystallized from acetonitrile to give 27.2 g (78%) of3-bromo-pyridin-2-ol. (77-1) [J. Am. Chem. Soc. 1982, 104, 4142-4146;Bioorg. Med. Chem. Lett. 2002, 12, 197-200; J Med Chem. 1979, 22,1284-1290.]

Molecular weight calcd. for C₅H₄BrNO: 173; (M+H)⁺ found: 174

Step T77-2. To a solution of 3-bromo-pyridin-2-ol (77-1, 5 g, 0.028mol), Ph₃P (11 g, 0.04 mol) and 2-(tert-butyldimethylsilanyloxy)-ethanol(77-A, 7 g, 0.04 mol) in 50 mL of THF was slowly addeddiethylazodicarboxylate (8.1 g, 0.04 mol) at room temperature. Theprogress of the reaction was easily monitored by TLC [hexanes/ethylacetate (4:1); R_(f)=0.5; detection: CMA]. The mixture was stirred atroom temperature for 24 h at which point the reaction was complete byTLC analysis. The solvent was removed under high vacuum and the residuepurified by flash chromatography to obtain 77-2 as a pale brown liquid(6.3 g, 68%). [Tetrahedron Lett. 1994, 35, 2819-2822; Tetrahedron Lett.1995, 36, 8917-8920; Synlett, 1995, 845-846. Heetrocycles 1990, 31,819-824.

Molecular weight calcd. for C₁₃H₂₂BrNO₂Si 331; (M+H)⁺ found: 332

Step T77-3. The protected alcohol 77-2 (3 g, 9.1 mmol) was dissolved indiisopropylamine (50 mL) and the reaction mixture degassed by bubblingargon through the solution. PdCl₂(PPh₃)₂ (410 mg, 0.61 mmol, 0.06 eq),CuI (74 mg, 0.4 mmol, 0.04 eq) and triphenylphosphine (310 mg, 1.12mmol) were added, then the mixture was warmed to 70° C. and stirred O/N.The solvent was removed under high vacuum and the residue was purifiedby flash chromatography to obtain 77-3 as a pale brown liquid (3.36 g,70%) [Org. Lett. 2003, 5, 2441-2444; J. Chem. Soc. Perkin. Trans I 1999,1505-1510; J. Org. Chem. 1993, 58, 2232-2243; J. Org. Chem. 1999, 58,95-99; Org. Lett. 2000, 2, 2291-2293; Org. Lett. 2002, 4, 2409-2412]

TLC (hexanes/ethyl acetate, 1:3): R_(f): =0.3; detection: CMA

Molecular weight calcd. for C₂₈H₄₀N₂O₆Si: 528; (M+H)⁺ found: 529

Step T77-4. The acetylene 77-3 (3 g, 5.67 mmol) was dissolved in EtOH(30 mL) and purged with nitrogen for 10 min. PtO₂ (10 mol %, 300 mg) wasadded and the mixture purged with a balloon full of hydrogen gas. Themixture was then charged into a Parr bomb, flushed with hydrogen (fillwith hydrogen at 80 psi then release and refill, repeat thisfill-release-refill cycle 3×), and maintained with hydrogen at 80 psi atroom temperature O/N. The reaction mixture was filtered through a pad ofCelite (use methanol for washing the residue on the Celite) and thefiltrate plus washings was concentrated under reduced pressure to afforda practically pure (clean ¹H NMR), but colored sample of 77-4 in aquantitative yield. Further purification was achieved by subjecting thismaterial to flash chromatography. The product 77-4 has the same R_(f) asthe starting material (77-3), hence, ¹H NMR is the best way todistinguish them.

TLC [(hexanes/ethyl acetate, 1:3); R_(f)=0.3 detection: CMA]

Molecular weight calcd. for C₂₈H₄₄N₂O₆Si: 532, (M+H)⁺ found: 533

Step T77-5. 77-4 (3 g, 5.6 mmol) was dissolved in anhydrous THF (200mL). To the clear solution was added TBAF (6.7 mmol, 7 mL) and themixture stirred for 2 h at room temperature. The solution was thenpoured into ice water. The aqueous solution was extracted withdichloromethane (3×200 mL). The organic layer was washed sequentiallywith saturated citrate buffer (1×200 mL), water (200 mL) and brine (200mL). The washed organic extract was dried over anhydrous sodium sulfate,filtered and evaporated to dryness under reduced pressure to give anoily residue. This syrup was purified by flash chromatography(hexanes/AcOEt, 1:2) to give Ddz-T77 as a syrup (2.10 g, yield 90%).

TLC (hexanes/AcOEt, 1:2): R_(f)=0.3; detection: ninhydrin

¹H NMR (CDCl₃): δ 1.73 (s, 6H), 1.75 (m, 2H), 2.65 (m, 2H), 3.15 (m,2H), 3.75 (s, 6H), 3.90 (m, 2H), 4.50 (m, 2H), 5.01 (sb, 1H), 6.30 (s,1H), 6.50 (s, 2H), 6.80 (m, 1H), 7.40 (m, 1H), 8.01 (m, 1H).

¹³C NMR (CDCl₃): δ 27.23 (CH₂), 29.24 (CH₃), 29.71 (CH₂), 40.17 (CH₂),55.44 (CH₃), 62.76 (CH₂), 69.11 (CH₂), 80.76 (Cq), 98.24 (CH), 103.24(CH), 117.54 (CH), 124.68 (Cq), 138.82 (CH), 144.17 (CH), 149.45 (Cq),155.50 (Cq), 160.84 (Cq), 162.03 (Cq).

Molecular weight calcd. for C₂₂H₃₀N₂O₆: 418; (M+H)⁺ found: 419

Example 2 Synthesis of Representative Macrocyclic Compounds

The following are provided as representative examples for themacrocyclic compounds of the invention. For solid phase methods, allyields are reported starting from 300-325 mg of PS-aminomethyl resin(loading 2.0 mmol/g) unless otherwise noted. Attachment of the firstbuilding block, BB₃, varies from 100% to 55% for the more difficultresidues, typically sterically crowded structures such as Ile or Val.The remaining couplings for BB₂ and BB₁ proceed in an average yield of80-90%. Attachment of the tether using the Mitsunobu reaction yieldsfrom 50-90% of the desired linear precursor. The macrocyclization itselfproceeds in an average yield of 20-50%. Minimal loss of yield occurs inpost-cyclization processing.

All the retention time values presented herein are based on the UVportion of the HPLC data. In the HPLC procedure, ELSD and CLND data (notlisted) were also procured to further assess purity of the finalproducts, and for quantification (CLND). All compounds were analyzedusing the same HPLC conditions. The details for the HPLC procedure usedwas as follows: Column: XTerra MS C18 4.6×50 mm, 3.5 μm, from Waters,HPLC: Alliance 2695 from Waters; MS: Platform LC from Micromass/Waters;CLND: 8060 from Antek; PDA: 996 from Waters; Gradient_B4. (i) 0 to 50%MeOH 0.1% aqueous TFA in 6 min, (ii) 3 min at 50% MeOH: 0.1% aqueousTFA; (iii) 50 to 90% MeOH: 0.1% aqueous TFA in 5 min; (iv) 3 min at 90%MeOH: 0.1% aqueous TFA. Retention time (t_(R)) for the compound islisted.

Modifications were made to the standard methods for compounds 58, 99,201, 203 and 215.

Compound 1

Yield: 33.4 mg pure macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, DMSO-d₆): δ 8.53, 8.41, 8.34 (doublets J=8.7 Hz forall, 1H); 8.13-8.06, 7.82-7.75 (multiplets, 1H); 7.30-7.05 (m, 8H);6.90-6.77 (m, 2H); 4.58-4.46, 4.40-4.29, 4.27-4.16 (multiplets, 1H);4.09-3.99, 3.97-3.82 (multiplets, 2H); 3.77-3.44 (m, 2H); 3.37-3.19 (m,4H); 3.15, 3.08 (2s, 2H); 2.98-2.86 (m, 5H); 2.52 (s, 3H); 1.94-1.75,1.60-1.30 (multiplets, 2H); 1.22 (br s, 4H); 0.86-0.75 (m, 3H).

HRMS calc. for C₂₉H₄₀N₄O₄; 508.3049. found 508.3040±0.0015.

HPLC t_(R)=8.94 min.

Compound 3

Yield: 33.0 mg pure macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, DMSO-d₆): δ 8.54 (d, J=9.4 Hz), 8.43-8.36 (m), and 8.12(br t, J=5.65 Hz) (1H); 7.90 (d, J=6.6 Hz), 7.79-7.72 (m) (1H);7.30-7.05 (m, 6H); 6.90-6.76 (m, 3H); 4.60-4.50 (m), 4.43 (d, J=18.3Hz), 4.26-4.16 (m) (1H); 4.13-4.02 (m, 1H); 4.01-3.84 (m, 2H); 3.74-3.41(m, 2H); 3.17, 3.09 (2s, 3H); 2.99-2.86 (m, 5H); 2.43-2.18 (m, 1H);1.97-1.75 (m, 3H); 1.72-1.39 (m, 1H); 0.96 (d, 5.76 Hz, 3H); 0.93-0.77(m, 2H); 0.68 (d, 5.76 Hz, 3H).

HRMS calc. for C₂₈H₃₈N₄O₄; 494.2893. found 494.2888±0.0015.

HPLC t_(R)=8.11 min.

Compound 4

Yield: 15.3 mg pure macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, CD₃CN); δ 7.48-7.19 (m, 6H); 7.13-6.98 (m, 3H);4.71-4.51 (m, 3H); 4.48-4.32 (m, 1H); 4.26-4.01 (m, 1H); 3.79-3.57 (m,2H); 3.48-3.20 (m, 3H); 3.19-3.06 (m, 5H); 3.01-2.89 (m, 2H); 2.80-2.62(m, 2H); 2.09-1.96 (m, 3H); 1.94-1.70 (m, 1H); 1.57-1.36 (m, 4H);1.32-1.26 (m, 1H); 1.08-0.97 (m, 3H).

HRMS calcd for C₂₉H₄₀N₄O₄; 508.3049. found 508.3045±0.0015

HPLC t_(R)=8.37 min

Compound 6

Yield: 28.2 mg macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, DMSO-d₆): δ 10.80 (s, 1H); 8.46 (d, J=9.65 Hz),8.36-8.28 (m), 8.14-8.07 (m), and 8.02 (d, J=9.65 Hz) (1H); 7.73-7.65(m), 7.59 (d, 8.2 Hz), and 7.51 (d, J=8.2 Hz) (1H); 7.3 (d, J=8.2 Hz,1H); 7.16-6.91 (m, 5H); 6.89-6.76 (m, 2H); 4.62-4.49 (m) and 4.42-4.24(m) (1H); 4.15-3.81 (m, 2H); 3.77-3.43 (m, 2H); 3.41-3.19 (m, 6H);3.22-2.85 (m, 6H); 2.52 (s, 3H); 1.89-1.69 (m, 1H); 1.59-1.02 (m, 4H);0.88-0.74 (m, 3H).

HRMS calc. for C₃₀H₃₉N₅O₄; 533.3002. found 533.2990±0.0016.

HPLC t_(R)=8.22 min.

Compound 8

Yield: 74.9 mg pure macrocycle was obtained (CLND quantification) from600-650 mg starting resin

¹H NMR (300 MHz, DMSO-d₆): δ 9.47 (br s), 9.07 (s) (1H) and 8.32 (br s)(2H); 7.94 (d, 6.6 Hz, 1H); 7.60-7.42 (m, 2H); 7.38 (d, 9.0 Hz, 1H);7.28-7.04 (m, 7H); 6.93 (t, 8.1 Hz, 1H); 6.60 (d, J=14.4 Hz) and6.39-6.27 (m) (1H); 4.51-4.38 (m, 1H); 4.29-4.08 (m, 2H); 3.87-3.63 (m,2H); 3.40-3.13 (m, 2H); 2.94 (t, J=14.1 Hz, 1H); 2.53-2.50 (m, 1H);2.32-2.17 (m, 1H); 1.86-1.06 (m, 10H); 0.95-0.79 (m, 6H).

HRMS calc. for C₃₂H₄₂N₄O₄; 546.3206. found 546.3198±0.0016.

HPLC t_(R)=9.02 min.

Compound 9

Yield: 33.7 mg pure macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, DMSO-d₆): δ 8.48 (s, 1H); 7.92 (d, J=5.3 Hz, 1H); 7.81(d, J=8.5 Hz, 1H); 7.26-7.08 (m, 7H); 6.88-6.75 (m, 2H); 4.30 (br t,J=10.1 Hz, 1H); 4.0 (t, J=8.6 Hz, 1H); 3.87 (br d, J=8.6 Hz, 1H);3.70-3.58 (m, 1H); 3.4-3.25 (m, 1H); 3.04-2.85 (m, 3H); 2.73 (d, 7.67Hz, 1H); 2.53 (s, 3H); 2.35-2.09 (m, 2H); 1.92-1.44 (m, 8H); 1.42-1.18(m, 2H); 0.85, 0.81 (2 doublets, J=6.76 Hz, 6H).

¹³C NMR (75 MHz, DMSO-d₆): δ 176.15; 173.20; 171.27; 157.18; 140.08;130.72; 130.52; 129.71; 128.64; 127.87; 126.62; 120.88; 111.44; 68.29;67.10; 66.99; 55.24; 48.42; 41.11; 41.03; 39.36; 36.93; 35.77; 34.65;32.38; 30.55; 29.96; 23.83; 22.65; 19.87.

HRMS calc. for C₃₁H₄₂N₄O₄; 534.3206. found 534.2139±0.0016.

HPLC t_(R)=9.29 min.

Compound 10

Yield: 19.2 mg pure macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, DMSO-d₆): δ 8.53, 8.41, 8.38 (doublets, J=8.8, 8.5, 8.5Hz, 1H); 8.16-8.05, 7.87-7.71 (multiplets, 1H); 7.31-7.04 (m, 7H);6.91-6.75 (m, 2H); 4.60-4.45, 4.39-4.30, 4.28-4.16 (m, 1H), 4.10-4.00,3.97-3.83 (m, 2H); 3.73-3.46 (m, 2H); 3.22-3.20 (m 1H), 3.16, 3.09 (2s,3H), 2.45-2.39 (m, 1H); 2.99-2.86 (m, 1H); 2.85-2.58 (m, 5H); 2.48-2.22(m, 1H); 2.07 (s, 1H), 1.95-1.78 (m, 1H), 1.75-1.42 (m, 1H), 1.42-1.17(m, 4H), 0.88-0.77 (m, 3H).

HRMS calc. for C₂₈H₃₈N₄O₄; 494.2893. found 494.2888±0.0015

HPLC t_(R)=8.27 min.

Compound 221

Yield: 50.3 mg macrocycle was obtained (CLND quantification).

¹H NMR (300 MHz, DMSO-d₆): δ 7.86 (d, J=6.7 Hz) and 7.65-7.58 (m) (1H);7.28-7.06 (m, 7H); 6.88 (d, 8.06 Hz, 1H); 6.81 (t, J=6.7 Hz, 1H);4.07-3.91 (m, 3H); 3.77-3.65 (m, 1H); 3.56-3.38 (m, 2H); 3.35-3.25 (m,3H); 3.25-3.07 (m, 2H); 3.04-2.63 (m, 3H); 2.52 (s, 3H); 2.01-1.71 (m,4H); 1.66-1.49 (m, 2H); 1.47-1.17 (m, 4H); 0.90-0.78 (m, 3H).

¹³C NMR (75 MHz, DMSO-d₆): δ 172.15; 170.81; 170.74; 157.29; 139.62;130.76; 130.56; 129.56; 128.82; 61.73; 59.29; 56.37; 47.90; 41.11;41.03; 39.36; 35.81; 35.43; 30.23; 30.03; 29.63; 25.12; 19.15; 14.66.

HRMS calc. for C₃₀H₄₀N₄O₄; 520.3049. found 520.3041±0.0016.

HPLC t_(R)=8.30 min.

Example 3 Alternative Synthetic Strategies

Alternative synthetic strategies amenable to larger scale synthesis ofcompounds of the present invention are discussed below.

A. Method LS1 for Representative Large Scale Synthesis of Compounds ofthe Invention

Step LS1-A: Synthesis of LS1-8

To alcohol Cbz-T33a (2.4 g, 7.0 mmol, 1.0 eq) in CH₂Cl₂ (50 mL) wereadded NBS (1.5 g, 8.4 mmol, 1.2 eq) and PPh₃ (2.2 g, 8.4 mmol, 1.2 eq).The mixture was stirred at room temperature O/N and a saturated aqueousNCl solution was added. The aqueous phase was extracted with CH₂Cl₂ (2×)and the combined organic phases were extracted with a saturated aqueousNH₄Cl solution to remove succinimide byproduct. The organic phase wasdried over MgSO₄ and concentrated under reduced pressure. The residuewas purified by flash chromatography (20% AcOEt, 80% hexanes) to givebromide LS1-8a as a yellow oil (2.6 g, 91%).

TLC (30% AcOEt, 70% hexanes); R_(f)=0.56; detection: UV and CMA

¹H NMR (CDCl₃): δ 7.37-7.26 (5H, m, Ph), 7.19-7.13 (2H, m, Ph), 6.90(1H, t, Ph), 6.83 (1H, d, Ph), 5.10 (2H, s, NHC(O)OCH ₂Ph), 4.96 (1H,broad, NHCbz), 4.59 (1H, sextuplet, PhOCH(CH₃)CH₂Br), 3.58-3.47 (2H, m,CH ₂Br), 3.19 (2H, q, CH ₂NHCbz), 2.67 (2H, t, PhCH ₂CH₂), 1.78 (2H,quint, PhCH₂CH ₂), 1.44 (3H, d, CHCH ₃).

LC/MS (Grad_A4): t_(R)=11.15 min

Step LS1-B1: Synthesis of LS1-10

The hydrochloride salt of H-Nva-OMe was dissolved in an aqueous solutionof Na₂CO₃ (1 M) and saturated with NaCl to ensure extraction of all ofthe free amine. The aqueous solution was extracted with AcOEt (3×). Thecombined organic phases were extracted with brine, dried over MgSO₄,filtered and concentrated under reduced pressure. The free amine,H-Nva-OMe, was recovered in 90% yield. It is important to perform thealkylation with the free amine (H-Nva-OMe) to eliminate chlorideformation (OTs to Cl) as a side reaction. In a dried round-bottomedflask, bromide LS1-8a (740 mg, 1.83 mmol, 1.0 eq) and H-Nva-OMe (479 mg,3.60 mmol, 2.0 eq) were added. Degassed (by stirring under vacuum for 30min) DMF (3.7 mL), anhydrous Na₂CO₃ (232 mg, 2.19 mmol, 1.2 eq) and KI(61 mg, 0.37 mmol, 0.2 eq) were added and the mixture stirred at 110° C.O/N. Water was added and the aqueous phase was extracted with Et₂O (3×).The combined organic phases were extracted with water (2×), then brine(1×). The organic phase was dried over MgSO₄, filtered and concentratedunder reduced pressure. The residue was purified by flash chromatography(30% AcOEt: 70% hexanes) to give secondary amine LS1-10 as a yellow oil(709 mg, 85%).

TLC (30% AcOEt, 70% hexanes); R_(f)=0.32; detection: UV and CMA,

¹H NMR (CDCl₃): δ 7.35-7.29 (5H, m, Ph), 7.17-7.12 (2H, m, Ph),6.91-6.84 (2H, m, Ph), 5.51 (1H, broad, CH₂NHCHRR′), 5.09 (2H, s, OCH₂Ph), 4.67-4.51 (1H, m, PhOCH(CH₃)R), 3.65 (3H, s, C(O)OCH ₃), 3.24-3.10(3H, m, NHCH(Pr)CO₂Me and CH ₂NHCbz), 2.87-2.41 (4H, m, PhCH ₂CH₂ andNHCH ₂CH(Me)OPh), 1.86-1.76 (2H, m, PhCH₂CH ₂), 1.70-1.63 (2H, m,CH₃CH₂CH ₂), 1.36-1.28 (2H, m, CH₃CH ₂CH₂), 1.23 (3H, d, CHCH ₃), 0.90(3H, t, CH ₃CH₂CH₂).

¹³C NMR (CDCl₃): δ 176.44, 156.88, 155.58, 137.14, 131.16, 130.57,128.68, 128.34, 128.21, 127.33, 120.79, 112.62, 73.16, 66.62, 61.30,54.21, 51.95, 40.86, 36.02, 30.60, 27.88, 19.20, 17.80, 14.07.

LC/MS (Grad_A4): t_(R)=6.76 min

Step LS1-B2: Alternative Synthesis of LS1-10

To a solution of alcohol Cbz-T33a (8.5 g, 24.7 mmol, 1.0 eq) in CH₂Cl₂(125 mL) were added Et₃N (10.4 mL, 74.1 mmol, 3.0 eq), TsCl (5.2 g, 27.2mmol, 1.1 eq) and DMAP (302 mg, 2.47 mmol, 0.1 eq). The mixture wasstirred O/N at room temperature and then an aqueous solution ofsaturated NH₄Cl was added. The aqueous phase was extracted with CH₂Cl₂(2×) and the combined organic phases were dried over MgSO₄, filtered andconcentrated under reduced pressure. The residue was purified by flashchromatography (30% AcOEt, 70% hexanes) to give tosylate LS1-8b as anoil (9.4 g, 90%).

TLC (50% AcOEt, 50% hexanes); R_(f)=0.47; detection: UV and CMA

¹H NMR (CDCl₃): δ 7.74 (2H, d, Ph), 7.36-7.26 (7H, m, Ph), 7.14-7.08(2H, m, Ph), 6.88 (1H, t, Ph), 6.74 (1H, d, Ph), 5.10 (2H, s, NHC(O)OCH₂Ph), 4.97 (1H, broad, NHCbz), 4.61-4.55 (1H, m, PhOCH(CH₃)CH₂OTs),4.19-4.05 (2H, m, CH ₂OTs), 3.15 (2H, q, CH ₂NHCbz), 2.56 (2H, td, PhCH₂CH₂), 2.42 (3H, s, PhCH ₃) 1.74 (2H, quint, PhCH₂CH ₂), 1.27 (3H, d,CHCH ₃)

¹³C NMR (CDCl₃): δ 156.67, 155.05, 145.20, 137.04, 133.02, 131.16,130.65, 130.11, 128.72, 128.28, 128.23, 128.10, 127.39, 121.50, 112.87,71.99, 71.42, 66.68, 40.79, 30.32, 27.57, 21.87, 16.74.

LC-MS (Grad_A4): t_(R)=11.02 min

Application of the procedure in Step LS1-BI, substituting the tosylateLS1-8b as alkylating agent gave 73% yield of LS1-10 with 2 eq ofH-Nva-OMe.

Step LS1-C1: Synthesis of LS1-7

To a solution of amine LS1-10 (697 mg, 1.53 mmol, 1.0 eq) in THF/H₂O(1:1, 15 mL) at 0° C. were added Na₂CO₃ (244 mg, 1.68 mmol, 1.5 eq) and(Boc)₂O (366 mg, 1.68 mmol, 1.1 eq), then the mixture stirred at roomtemperature for 36-48 h. THF was evaporated under reduced pressure andthe aqueous phase was extracted with Et₂O (3×). The combined organicphases were extracted with brine, dried over MgSO₄, filtered andconcentrated under reduced pressure. The Boc compound was obtained as ayellow oil and used without further purification for the next reaction.

TLC (30% AcOEt, 70% hexane): R_(f)=0.49; detection: UV and CMA

To a solution of the crude Boc compound in THF/H₂O (1:1, 15 mL) wasadded LiOH (309 mg, 7.35 mmol, 5.0 eq) and the mixture stirred O/N atrt. THF was evaporated under reduced pressure and the remaining aqueousbasic phase was then acidified with 1 M HCl to pH 3 (pH paper). Theaqueous phase was extracted with AcOEt and the combined organic phaseswere extracted with water and brine. The organic phase was dried overMgSO₄, filtered and concentrated under reduced pressure. Carboxylic acidLS1-7 was obtained as a yellow oil (687 mg, 83%, 2 steps).

TLC (50% AcOEt, 50% hexane); R_(f)=0.32; detection: UV and CMA

¹³C NMR (CDCl₃): δ 176.11, 156.81, 155.51, 155.18, 136.93, 131.13,130.37, 128.72, 128.31, 127.44, 121.20, 113.70, 81.36, 73.40, 66.79,61.99, 40.80, 32.83, 31.56, 30.33, 28.48, 27.48, 20.10, 17.53, 14.11.

LC/MS (Grad_A4): t_(R)=12.50 min

Step LS1-C2: Divergent Synthetic Route (No Amine Protection)

The H-Nva-OtBu.HCl was dissolved in an aqueous solution of Na₂CO₃ (1 M)and saturated with NaCl to ensure extraction of all of the free amine.This aqueous solution was extracted with AcOEt (3×). The combinedorganic phases were extracted with brine, dried over MgSO₄, filtered andconcentrated under reduced pressure. About 90% of the free amine,H-Nva-OtBu, was recovered. It is important to perform the alkylationwith the free amine (H-Nva-OtBu) to eliminate chloride side productformation (OTs-> Cl).

In a dried round-bottomed flask, tosylate LS1-8b (1.0 g, 2.01 mmol, 1.0eq) and H-Nva-OtBu (752 mg, 4.02 mmol, 2.0 eq) were added. Degassed (bystirring under vacuum for 30 min) DMF (4 mL) and anhydrous Na₂CO₃ (256mg, 2.41 mmol, 1.2 eq, note that other bases were less effective) wereadded and the mixture stirred at 110° C. O/N. Water was added and theaqueous phase extracted with Et₂O (3×). The combined organic phases wereextracted with water (2×) and brine (1×). The organic phase was driedover MgSO₄, filtered and concentrated under reduced pressure. Theresidue was purified by flash chromatography (30% AcOEt: 70% hexanes) togive the amine, LS1-12, as a yellow oil (683 mg, 75%). This crudesecondary amine (1.0 eq) was dissolved in 4 M HCl/dioxane (10 eq) andthe mixture stirred O/N at room temperature. The solvent was evaporatedunder reduced pressure and Et₂O added to the residue. A whiteprecipitate was formed upon addition of heaxnes to this mixture. Theprecipitate was filtered and rinsed with cold hexanes to give thedesired amino acid, LS1-13, as a white solid.

TLC (50% AcOEt, 50% hexane); R_(f)=0.71; detection: UV and CMA

LS1-13, despite the presence of the free amine, has been used in theremaining part of the synthetic scheme to successfully access thedesired macrocycle.

Step LS1-D: Synthesis of Dipeptide LS1-6

The tosylate salt of H-(D)Phe-OBn was dissolved in an aqueous solutionof 1 M Na₂CO₃ and the aqueous solution extracted with AcOEt (3×). Thecombined organic phases were extracted with brine, dried over MgSO₄,filtered and concentrated under reduced pressure. The free amineH-(D)Phe-OBn was recovered in 90% yield. To a solution of H-(D)Phe-OBn(3.0 g, 11.76 mmol, 1.0 eq) in THF/CH₂Cl₂ 1/1 (60 mL) were addedBoc-(D)NMeAla-OH (2.5 g, 12.35 mmol, 1.05 eq), 6-Cl HOBt (2.0 g, 11.76mmol, 1.0 eq) and DIPEA (10.2 mL, 58.8 mmol, 5.0 eq). The mixture wascooled to 0° C. and EDCI (2.48 g, 12.94=mol, 1.1 eq) was added. Themixture was stirred 1 h at 0° C. and at room temperature O/N. Solventwas evaporated under reduced pressure and the residue dissolved inAcOEt. The organic phase was washed sequentially with an aqueous 1 Msolution of citrate buffer (pH 3.5, 2×), an aqueous solution ofsaturated NaHCO₃ (2×) and brine (1×). The organic phase was dried overMgSO₄, filtered and concentrated under reduced pressure. The dipeptidewas obtained as a yellow oil and used as obtained for the next step (5.3g, 100%). The dipeptide was dissolved in a solution of HCl/dioxane (4 M,30 mL, 10 eq), 50 mL of dioxane were then added to facilitate theagitation and the mixture stirred for 1 h at room temperature; aheterogeneous solution was obtained. The mixture was concentrated underreduced pressure and dried further on mechanical vacuum pump. Thedipeptide hydrochloride salt LS1-6 was obtained as pale yellow solid(4.4 g, 100%).

¹H NMR (DMSO-d₆): δ 9.40-8.70 (3H, d and 2 broads, C(O)NH and CH₃NH ₂⁺Cl⁻), 7.39-7.17 (10H, m, Ph), 5.11 (2H, s, C(O)OCH ₂Ph), 4.69-4.61 (1H,m, CHCH₃), 3.69 (1H, dd, CHCH₂Ph), 3.31 (3H, s, CH ₃NH₂ ⁺Cl⁻), 3.17-3.11and 2.97-2.90 (CHCH ₂Ph), 1.28 (3H, d, CHCH ₃)

¹³C NMR (DMSO-d₆): δ 171.33, 169.18, 137.63, 136.31, 129.92, 129.11,128.95, 128.83, 128.63, 127.30, 67.00, 56.57, 54.38, 36.98, 31.11,16.47.

LC/MS (Grad_A4): t_(R)=6.17 min

Step LS1-E: Synthesis of Amino Acid LS1-5

To a solution of acid LS1-7 (1.45 g, 2.67 mmol, 1.05 eq) in THF/CH₂Cl₂1/1 (13 mL) at 0° C. were added hydrochloride salt LS1-6 (958 mg, 2.55mmol, 1.0 eq), DIPEA (2.2 mL, 12.8 mmol, 5.0 eq) and HATU (1.07 g, 2.81mmol, 1.1 eq). The mixture was stirred at room temperature O/N. Solventwas evaporated and the residue was dissolved in AcOEt. The organic phasewas washed sequentially with an aqueous solution of 1 M citrate buffer(pH=3.5, 2×), aqueous solution of saturated NaHCO₃ (2×), then with brine(1×). The organic phase was dried over MgSO₄, filtered and concentratedunder reduced pressure. The residue was purified by flash chromatography(gradient: 20% AcOEt, 80% hexanes to 30% AcOEt, 70% hexanes) to give thedesired fully protected tripeptide as a pale yellow gummy foam (1.6 g,73%).

TLC (50% AcOEt, 50% hexanes): R_(f)=0.78; detection: UV and CMA

LC/MS (Grad_A4): t_(R)=15.15 min

To a solution of the protected, alkylated tripeptide (1.5 g, 1.75 mmol,1.0 eq) in AcOEt (23 μL) was added 10% Pd/C (20% by weight, 315 mg) andthen hydrogen was bubbled through the solution. The mixture was stirredO/N under a hydrogen atmosphere. Nitrogen was bubbled through thereaction, then the mixture filtered on a Celite pad and rinsed withAcOEt. The combined filtrate was evaporated under reduced pressure togive LS1-5 as a white solid (1.1 g, quantitative).

TLC (50% AcOEt, 50% hexanes): R_(f)=0.52; detection: UV and CMA

LCMS (Grad_A4): t_(R)=8.23 min

Step LS1-F: Macrocyclization and Final Deprotection

To a solution of cyclization precursor LS1-5 (50 mg, 0.08 mmol, 1.0 eq)in THF (3.2 mL, for a concentration of 25 mM) was added DIPEA (68 μL,0.39 mmol, 5.0 eq) and DEPBT (28 mg, 0.094 mmol, 1.2 eq) and the mixturestirred at room temperature O/N. Solvent was evaporated under reducedpressure and the residue purified by flash chromatography (1% MeOH, 99%CH₂Cl₂) to give Boc-protected macrocycle LS1-11 as a white solid (40 mg,0.064 mmol, 80%). On a 1 g scale of precursor LS1-5 at a reactionconcentration of 25 mM, the yield was 73%.

TLC (5:95 MeOH:DCM): R_(f)=0.43; detection: UV and CMA

¹H NMR (DMSO-d₆ 60° C.): δ 7.62 (1H, d, NH), 7.47 (1H, broad, NH),7.27-7.08 (7H, m, Ph), 6.85-6.79 (2H, m, Ph), 4.78 (1H, broad),4.51-4.38 (1H, m), 4.11-4.02 (2H, m), 3.62-3.56 (1H, m), 3.32-3.04 (5H,m), 2.92 (3H, s, N—CH ₃), 2.72-2.46 (2H, m), 1.90-1.59 (4H, m), 1.46(9H, s, C(CH ₃)₃), 1.28-1.06 (8H, m), 0.65 (3H, t, CH₂CH ₃).

¹³C NMR (DMSO-d₆): δ 172.03, 171.07, 155.83, 155.60, 139.69, 131.82,130.82, 129.69, 128.73, 127.73, 126.75, 121.06, 113.40, 80.66, 74.75,57.22, 56.66, 50.49, 35.88, 33.72, 32.71, 30.41, 28.68, 19.35, 18.44,14.95, 14.19.

LC-MS (Grad_A4): t_(R)=12.82 min

Macrocycle LS1-11 (565 mg, 0.91 mmol, 1.0 eq) was dissolved in asolution of 4 M HCl/dioxane (4.6 mL, 20 eq) and the mixture stirred 2 hat room temperature. The mixture was concentrated under reduced pressureand placed under vacuum (oil pump) to give final macrocycle Compound 410as a white solid (508 mg, 100%).Chiral HPLC indicated no racemization when compared to its (L)-antipodeat position AA3.

¹H NMR (DMSO-d₆, 60° C.): δ 9.38 (1H, broad), 8.28 (1H, d), 8.13 (1H,broad), 7.81 (1H, t), 7.28-7.13 (7H, m, Ph), 6.93-6.87 (2H, m, Ph),4.84-4.77 (1H, m), 4.54-4.40 (3H, m), 3.35-3.07 (6H, m), 2.94 (3H, s,N—CH ₃), 2.90-2.81 and 2.64-2.47 (2H, m), 1.85-1.64 (4H, m), 1.38-1.21(5H, m), 1.10 (3H, d, CH ₃), 0.88 (3H, t, CH₂CH ₃).

¹³C NMR (CDCl₃): δ 171.92, 171.46, 170.44, 155.11, 139.07, 131.68,130.47, 129.87, 128.67, 127.54, 126.90, 121.50, 112.94, 69.83, 67.03,58.14, 56.33, 55.61, 55.29, 53.88, 50.48, 37.29, 32.29, 31.08, 29.70,28.58, 18.15, 17.89, 15.20, 14.55.

LC-MS (Grad_A4): t_(R)=6.23 min

LC chiral (Grad35A-05): t_(R)=26.49 min

LC chiral (Grad40A-05): t_(R)=26.54 min

B. Method LS2 for Representative Large Scale Synthesis of Compounds ofthe Invention

Step LS2-A: Synthesis of Dipeptide LS2-21

A stirred suspension of H-(D)Phe-OtBu.HCl (5 g, 0.02 mol, 1 eq) andZ-(D)NMeAla-OH (4.98 g, 0.021 mol, 1.05 eq) in 130 mL of anhydrousTHF-DCM (1:1) at room temperature was treated with DIPEA (17.50 mL, 0.1mol, 5 eq) and 6-Cl-HOBt (3.40 g, 0.02 mol, 1 eq). The mixture wasstirred vigorously at room temperature for several minutes, cooled withan ice bath, then EDCI (4.20 g, 0.022 mol, 1.1 eq) was added and themixture stirred for 1 h. After this period of time, the ice bath wasremoved and the reaction was stirred at room temperature O/N. Thesolvent was removed under reduced pressure and the residue dissolved in100 mL of AcOEt and washed with citrate buffer solution (1 N, 2×100 mL),saturated NaHCO₃ solution (2×100 mL) and brine. The organic layer wasdried over anhydrous sodium sulfate, filtered and evaporated to drynessunder reduced pressure to give 9.25 g (100%) of a colorless oil, LS2-24.

TLC (hexanes/ethyl acetate, 1:1): R_(f) 0.3; detection: CMA and UV

¹H NMR (CDCl₃): δ 1.25 (m, 2H), 1.40 (s, 9H), 2.66 (s. 3H), 2.85 (dd,1H), 3.15 (dd, 1H), 4.70 (q, 2H), 5.15 (s, 2H), 6.50 (sb, 1H), 7.15 (m,2H), 7.20 (m, 3H), 7.35 (m, 5H).

¹³C NMR (CDCl₃): δ 28.18, 38.23, 53.61, 53.61, 67.87, 127.12, 128.40,128.19, 128.40, 128.61, 128.8, 129.53, 170.01.

LC/MS (Grad_A4); t_(R)=9.73 min; Mass found: 440

Dipeptide LS2-24 (6.9 g, 0.015 mol) was dissolved in AcOEt (100 mL),then purged with nitrogen for 10 min. 10% Pd—C (690 mg) was added andthe mixture purged with a balloon full of hydrogen gas. The mixture wasthen hydrogenated under atmospheric pressure using a H₂ balloon. After12 h, the reaction mixture was filtered through a short pad of Celite,and the filter cake washed with AcOEt. The combined filtrate andwashings were concentrated under reduced pressure to afford practicallypure (clean NMR), colorless, solid compound LS2-21 (4.30 g, 90%) whichwas used directly in the next step without further purification.

TLC (100% AcOEt): R_(f)=0.1; detection: CMA and UV.

¹H NMR (CDCl₃): δ 1.20 (d J=7.03 Hz, 3H) (s, 9H), 2.40 (s, 1H),3.01-3.20 (m, 3H), 4.80 (q, 1H), 7.20 (m, 5H), 7.60 (m, 1H).

¹³C NMR (CDCl₃): δ 19.64, 28.18, 35.12, 38.46, 53.06, 60.42, 82.29,127.05, 128.50, 129.71, 136.61, 170.85, 174.28.

LC-MS (Grad_A4): t_(R)=5.86 min; Mass found: 306

Step LS2-B: Synthesis of Tripeptide LS2-22

A stirred suspension of dipeptide LS2-21 (2 g, 6.50 mmol, 1 eq) andBts-Nva-OH (LS2-28, 2.15 g, 6.85 mmol, 1.05 eq) in 32 mL of anhydrousDCM at 0° C. was treated with DIPEA (4.50 mL, 0.026 mol, 4 eq) and HATU(2.72 g, 7.18 mmol, 1.1 eq). The mixture was stirred vigorously at 0° C.for 1 h. After this period of time, the ice bath was removed and thereaction stirred at room temperature O/N. The solvent was removed invacuo and the residue dissolved in 30 mL of AcOEt. The organic phase wassequentially washed with 1 N citrate buffer solution (2×30 mL),saturated NaHCO₃ solution (2×30 mL) and brine (1×30 mL). The organiclayer was then dried over anhydrous sodium sulfate, filtered andevaporated to dryness under reduced pressure. The residue was purifiedby flash chromatography [ethyl acetate/hexanes (1/1)] to afford LS2-22as a colorless solid (3.13 g, 80%).

TLC (hexanes/ethyl acetate, 3:2): R_(f)=0.3; detection: CMA and UV

¹H NMR (CDCl₃): δ0.95 (m, 3H), 1.20 (d, 2H), 1.40 (s, 9H), 1.42-1.70 (m,4H), 2.60 (m, 2H), 2.90 (s, 3H), 4.40 (m, 1H), 4.80 (m, 1H), 4.92 (m,1H), 6.10 (m, 1H), 6.30 (M, 1H), 6.40 (m, 1H), 6.90 (m, 2H), 7.20 (m,3H), 7.40-7.60 (m, 2H), 7.90 (m, 1H), 8.10 (m, 1H).

¹³C NMR (CDCl₃): δ 23.42, 26.32, 33.12, 48.63, 49.10, 49.85, 77.56,117.63, 120.67, 122.35, 122.93, 123.11, 123.80, 124.13, 124.68, 124.75,131.45, 147.67, 165.16, 165.68, 167.66.

LC-MS (Grad_A4): t_(R)=11.48 min; Mass found: 602

Step LS2-C: Synthesis of LS2-23

A stirred suspension of tripeptide LS2-22 (0.4 g, 0.66 mmol) and tetherbromide LS2-9 (0.5 g, 1.32 mmol, synthesized as in Step LS1-A for thecorresponding Cbz derivative) in 1.33 mL of anhydrous DMF at roomtemperature was treated with KI (0.12 g, 0.66 mmol) and K₂CO₃ (0.185 g,1.32 mmol). The mixture was stirred vigorously at 80° C. for 24 hours.After this period of time, this mixture was cooled to room temperature,then 20 ml of water was added and the product extracted with Et₂O (3×30mL). The combined organic layer was washed with brine (2×30 mL), driedover magnesium sulfate and concentrated under vacuum. The residue waspurified by flash chromatography [hexanes/ethyl acetate (1:2)] to affordLS2-25 as a white solid (70%).

TLC (hexanes/ethyl acetate, 2:1): R_(f)=0.4; detection: CMA and UV

¹H NMR (DMSO-d₆): δ0.5 (m, 1H), 0.70 (m, 1H), 1.01-1.40 (m,) 1.60 (m,3H), 1.80 (m, 1H), 2.55 (m,), 2.95 (m, 4H), 3.1 (m, 2), 3.30 (m, 2H),3.60 (m, 1H), 3.90 (m, 1H), 4.30 (m, 1H), 4.80 (m,), 6.80 (m, 3H), 7.05(m, 6H), 7.60 (2H), 7.95 (m, 1H), 8.20 (m, 1H), 8.25 (m, 1H), 8.90 (s,2H).

¹³C NMR (CDCl₃): δ 13.84, 15.36, 17.40, 17.70, 19.40, 22.17, 27.52,28.14, 28.67, 30.29, 31.27, 33.27, 38.01, 40.35, 51.02, 53.08, 54.35,56.72, 70.25, 73.13, 81.10, 113.49, 120.94, 122.28, 125.44, 127.01,127.19, 127.19, 127.68, 127.68, 127.79, 128.64, 129.57, 130.06, 136.2,137.10, 165.10, 170.10, 171.10.

LC-MS (Grad_A4): t_(R)=15.10 min; Mass found: 892

100 mg of alkylated tripeptide LS2-25 (100 mg, 0.11 μmol) was treatedwith 2 mL of 50% TFA, 3% triethylsilane (TES) in DCM, then the mixturestirred for 1 h at room temperature. After this period of time, allsolvents were removed under reduced pressure. The crude compound LS2-23was dried using vacuum pump for 1 h and used directly in the next stepwithout further purification.

LC/MS (Grad_A4): t_(R)=8.55 min; Mass found: 737

Step LS2-D: Synthesis of LS2-26 (Macrolactamization)

To a stirred suspension of alkylated-tripeptide 23 (0.12 mmol) and DIPEA(0.100 mL, 0.56 mmol) in 11.22 mL of anhydrous THF at room temperaturewas added DEPBT (41 mg, 0.14 mmol). The mixture was stirred vigorouslyat room temperature O/N. The reaction was then concentrated to drynessunder reduced pressure and the residue dissolved in 10 mL of AcOEt. Theorganic solution was sequentially washed with citrate buffer solution (1N, 2×30 mL), saturated NaHCO₃ (2×30 mL) and brine (1×30 mL). The organiclayer was dried over anhydrous sodium sulfate, filtered and evaporatedto dryness under reduced pressure. The residue was purified by flashchromatography using [ethyl acetate/hexanes (3:1)] to afford LS2-26(Bts-410) as a white solid (80 mg, 98%).

TLC (ethyl acetate/hexanes, 3:1): R_(f)=0.3; detection: CMA and UV

¹H NMR (CDCl₃): δ 0.64 (m, 3H), 0.87 (m, 1H), 1.02 (m, 2H), 1.20 (m,6H), 1.40 (m, 3H), 1.60 (m, 4H), 1.80 (m, 1H), 2.01 (m, 1H), 2.40 (m,1H), 2.80 (m, 1H), 3.15 (s, 3H), 3.20 (m, 2H), 3.45 (m, 1H), 3.60-3.80(m, 2H), 4.40-4.60 (dd, 2H), 4.70 (m, 2H), 5.01 (m, 1H), 5.90 (m, 1H),6.80 (m, 2H), 6.90 (m, 1H), 7.15-7.25 (m, 7H), 7.60 (m, 2H), 8.01 (m,1H), 8.10 (m, 1H).

¹³C NMR (CDCl₃): δ 13.28, 13.55, 18.75, 18.98, 28.89, 29.92, 29.92,33.19, 36.81, 36.98, 39.55, 51.94, 53.83, 55.25, 59.51, 74.64, 111.66,120.64, 122.51, 125.15, 127.10, 127.37, 127.84, 128.07, 128.86, 129.47,130.51, 136.55, 137.30, 152.58, 155.86, 165.33, 169.75, 170.09, 171.66.

LC/MS (Grad_A4): t_(R)=13.17 min; Mass found: 719

LC Chiral (column ODRH, Grad 55A-05): t_(R)=42.059.

Step LS2-E: Synthesis of Compound 410

To a stirred suspension of macrocycle LS2-26 (40 mg, 0.003 mmol) in0.110 mL of DMF was added 23 mg of K₂CO₃ and 10 μl of mercaptopropanoicacid at room temperature, then the reaction left O/N. The reaction wasconcentrated to dryness under reduced pressure and the crude residuedissolved in 10 mL of AcOEt. The organic solution was washed with asaturated solution of NaHCO₃ (2×30 mL), ten brine (1×30 mL). The organiclayer was dried over anhydrous sodium, sulfate, filtered and evaporatedto dryness under reduced pressure. Compound 410 was thus isolated in 90%yield.

TLC (100% AcOEt): R_(f)=0.2; detection: CMA and UV

¹H NMR (DMSO-d₆): δ 0.79 (m, 3H), 1.20 (m, 9H), 1.30 (M, 1H), 1.60 (m,1H), 1.90 (m, 1H), 2.10 (Sb, 1H), 2.35 (ddd, J=4.98, 4.95, 4.69 Hz, 1H),2.56 (Sb, 1H), 2.63 (m, 1H), 2.80 (ddd, J=4.99, 4.69, 4.40 Hz, 1H),3.01-3.15 (m, 5H), 3.25 (dd, J=4.69, 4.11 Hz, 1H), 3.30 (s, 2H), 3.55(sb, 1H), 3.95 (q, J=7.33, 7.04 Hz, 1H), 4.50 (sb, 1H), 6.80 (m, 1H),6.90 (m, 1H), 7.10-7.30 (m, 7H), 7.70 (m, 2H).

¹³C NMR (DMSO-d₆): δ 14.60, 14.84, 18.46, 18.85, 29.80, 29.96, 34.03,35.84, 36.31, 40.68, 54.79, 55.67, 57.77, 58.11, 73.42, 112.26, 120.58,126.84, 127.81, 128.80, 129.73, 131.10, 140.10, 158.10, 172.10, 172.40,176.10.

LC/MS (Grad_A4): t_(R)=6.19 min; Mass found: 522

Example 4 Synthesis and Biological Results for Representative Compound298

A. Solution Synthesis of Compound 298

Step LS3-1. Synthesis of cyclopropylglycine methyl ester hydrochloridesalt. To a suspension of H-Cpg-OH (LS3-A, 20.0 g, 174 mmol, 1.0 eq) inanhydrous MeOH (350 mL) at 0° C. was slowly added freshly distilled(from PCl₅) acetyl chloride (185 mL, 2.6 mol, 15 eq) over 45 min. Themixture was allowed to warm to room temperature and stirred 16-18 h. Thereaction was monitored by TLC [MeOH/NH₄OH/AcOEt (10:2:88); detection:ninhydrin; R_(f)=0.50]. The mixture was then concentrated under vacuum,azeotroped with toluene (3×) and dried under high vacuum 16-18 h to giveLS3-1 as a pale yellow solid (30.0 g, >100% crude yield).

¹H NMR (CD₃OD): δ 4.88 (3H, s, NH ₃ ⁺), 3.85 (3H, s, CH ₃O), 3.36-3.33(1H, d, NH₃ ⁺CHCH₃O), 1.19-1.10 (1H, m, CH(CH₂)₂), 0.83-0.53 (4H, m,CH(CH ₂)₂).

Step LS3-2. Synthesis of tether bromide. To crude alcohol Cbz-T33a (21.5g, 62.6 mmol, 1.0 eq) in anhydrous CH₂Cl₂ (250 mL) were added NBS (12.8g, 72.0 mmol, 1.15 eq, larger amounts of NBS lead to dibrominated sideproduct) and PPh₃ (18.9 g, 72.0 mmol, 1.15 eq). The round bottom flaskwas protected from light with foil and the mixture stirred at roomtemperature 16-18 h with monitoring by TLC [AcOEt/Hexanes (3:7);detection: UV and CMA; R_(f)=0.42]. A saturated aqueous NCl solution(200 mL) was added and the aqueous phase extracted with CH₂Cl₂ (2×150mL). The combined organic phases were washed with a saturated aqueousNH₄Cl solution (2×200 mL), dried over MgSO₄, filtered and concentratedunder reduced pressure. The residue was purified by flash chromatography(AcOEt:hexanes, gradient, 5:95 to 15:85) to give bromide LS3-2 as aslightly yellow oil (22.2 g, 88.4%).

¹H NMR (CDCl₃): δ 7.37-7.26 (5H, m, Ph), 7.19-7.13 (2H, m, Ph),6.92-6.88 (1H, t, Ph), 6.84-6.81 (1H, d, Ph), 5.10 (2H, s, NHC(O)OCH₂Ph), 4.96 (1H, broad, NHCbz), 4.62-4.56 (1H, sextuplet,PhOCH(CH₃)CH₂Br), 3.58-3.45 (2H, m, CH ₂Br), 3.22-3.16 (2H, q, CHNHCbz),2.69-2.64 (2H, t, PhCH ₂CH₂), 1.83-1.78 (2H, quint, PhCH₂CH ₂), 1.45(3H, d, CHCH ₃).

¹³C NMR (CDCl₃): δ 156.66, 155.08, 136.99, 131.28, 130.77, 128.75,128.32, 128.28, 127.49, 121.56, 113.03, 73.12, 66.76, 40.69, 36.12,30.45, 27.48, 19.00.

LC/MS (Grad_A4): t_(R)=11.04 min

Step LS3-3. The hydrochloride salt LS3-1 was dissolved in an aqueoussolution of Na₂CO₃ (1 M, 275 mL, 0.272 mol, 1.5 eq). The basic aqueousphase was saturated with NaCl and extracted with AcOEt/CH₂Cl₂ (2:1)(5×100 mL). TLC [MeOH/NH₄OH/AcOEt (10:2:88); detection: ninhydrin;R_(f)=0.50]. The combined organic phases were dried over MgSO₄, filteredand concentrated under low vacuum at room temperature to give freeamino-ester LS3-3 as a yellow oil (19.1 g, 85%, 2 steps). LS3-3 isvolatile and should not be left on a mechanical vacuum pump for extendedperiods of time. To minimize diketopiperazine formation, Step LS3-4should occur immediately after isolation of LS3-3.

¹H NMR (CDCl₃): δ 3.70 (3H, s, CH ₃O), 2.88-2.85 (1H, d, NH₂CHCH₃O),1.54 (1H, s, NH₂), 1.04-0.97 (1H, m, CH(CH₂)₂), 0.56-0.27 (4H, m,CH(CH)₂).

Step LS3-4. In a dried round-bottom flask, bromide LS3-2 (47.2 g, 117mmol, 1.0 eq) and freshly prepared LS3-3 (19.1 g, 148 mmol, 1.2 eq) wereadded. Degassed anhydrous DMF (117 mL), anhydrous Na₂CO₃ (14.8 g, 140mmol, 1.2 eq) and KI (19.4 g, 117 mmol, 1.0 eq) were added and themixture was stirred at 100° C. under a nitrogen atmosphere for 16-18 h.Reaction progress was monitored by LC-MS and/or TLC. The mixture wascooled down to room temperature and water (200 mL) added and the aqueousphase extracted with MTBE (3×100 mL). The combined organic phases werewashed sequentially with water (2×100 mL) and brine (1×100 mL), driedover MgSO₄, filtered and concentrated under reduced pressure. Theresidue was purified by flash chromatography [hexanes/AcOEt/DCM,gradient (85:10:5) to (50:45:5)] to give LS3-4 as an orange oil (43.1 g,81%).

TLC [hexanes/AcOEt (1:1)]: R_(f)=0.35; detection: UV and CMA

¹H NMR (CDCl₃): δ 7.31-7.22 (5H, m, Ph), 7.07-7.03 (2H, m, Ph),6.80-6.74 (2H, m, Ph), 5.48 (1H, broad, CH₂NHCHRR′), 5.00 (2H, s, OCH₂Ph), 4.49-4.43 (1H, m, PhOCH(CH₃)R), 3.56 (3H, s, C(O)OCH ₃), 3.18-3.11(3H, m, NHCH(Pr)CO₂Me and CH ₂NHCbz), 2.75-2.50 (4H, m, PhCH ₂CH₂ andNHCH ₂CH(Me)OPh), 1.76-1.68 (2H, m, PhCH₂CH ₂), 1.19-1.14 (3H, d,PhOCH(CH ₃)R), 0.88-0.80 (1H, m, CH(CH₂)₂), 0.46-0.13 (4H, m, CH(CH₂)₂).

LC/MS (Grad_A4): t_(R)=6.63 min

Step LS3-5. To a solution of secondary amine LS3-4 (43.0 g, 94.7 mmol,1.0 eq) in THF/H₂O (1:1, 475 mL) at 0° C. were added Na₂CO₃ (15.1 g,113.7 mmol, 1.5 eq) and (Boc)₂O (24.8 g, 142.1 mmol, 1.2 eq). Themixture was allowed to warm to room temperature and stirred 24 h.Reaction was monitored by LC/MS and/or TLC. THF was evaporated undervacuum and the residual aqueous phase was extracted with MTBE (3×100mL). The combined organic phases were washed with brine (1×100 mL),dried over MgSO₄, filtered and evaporated under vacuum to give the crudeLS3-5 as an orange oil (59.1 g, >100% crude yield).

TLC [hexanes/AcOEt (1:1)]: R_(f) 0.57; detection: UV and CMA

LC/MS (Grad_A4): 12.98 min.

Step LS3-6. To a solution of LS3-5 (52.5 g, 94.7 mmol, 1.0 eq.) inTHF/H₂O (1:1, 475 mL) at room temperature was added LiOH monohydrate(19.9 g, 474 mmol, 5.0 eq.). The mixture was stirred 16-18 h at roomtemperature. The reaction was monitored by LC/MS (Grad_A4): t_(R)=12.21min. TLC [Hexanes/AcOEt (1:1); detection: UV and CMA; R_(f) baseline].The reaction mixture was acidified with citrate buffer (1M, pH 3.5) andTHF was then evaporated under vacuum. The residual aqueous phase wasextracted with AcOEt (3×150 mL), then the combined organic phases washedwith brine (1×100 mL), dried over MgSO₄, filtered and concentrated underreduced pressure to give carboxylic acid LS3-6 as a white gummy solid(47.3 g, 93% for 2 steps).

LC/MS (Grad_A4): t_(R)=12.16 min

Step LS3-7. To a suspension of H-(D)Phe(4F)—OH (LS3-B, 55.6 g, 0.30 mol,1.0 eq) in benzene (1.2 L) was added p-TSA (69.4 g, 0.37 mol, 1.2 eq)and benzyl alcohol (157 mL, 1.52 mol, 5.0 eq). The mixture was stirredat reflux 16-18 h in a Dean-Stark apparatus during which a homogeneoussolution was obtained. The mixture was cooled down to room temperatureand a white precipitate formed. The precipitate was diluted with Et₂O(500 mL), filtered and triturated with Et₂O (3×500 mL). The solid wasdried under vacuum to give LS3-7 as a white solid (126 g, 93.1%).Substitution of toluene for benzene resulted in reduced reaction time,2-3 h.

¹H NMR (DMSO-d₆): δ 8.40 (3H, bs, NH₃Cl), 7.47-7.36 (2H, d, Ph),7.37-7.06 (11H, m, Ph), 5.15 (2H, s, OCH ₂Ph), 4.37 (1H, bt, CHCH₂Ph),3.09-3.05 (2H, m, CHCH ₂Ph), 2.27 (3H, s, CH ₃Ph).

¹³C NMR (DMSO-d₆): δ 169.52 163.83, 160.62, 140.01, 138.56, 135.48,132.16, 132.04, 131.33, 131.28, 129.09, 129.05, 128.84, 128.72, 127.09,126.20, 116.18, 115.89, 67.83, 53.88, 35.83, 21.47.

LC/MS (Grad_A4): t_(R)=6.12 min

Melting point (uncorrected): 165-167° C.

Step LS3-8._The tosylate salt LS3-7 (122 g) was taken up in an aqueoussolution of Na₂CO₃ (1 M, 500 mL). The resulting basic aqueous solutionwas extracted with AcOEt (4×500 mL) and the combined organic phases werewashed with brine (1×250 mL), dried over MgSO₄, filtered andconcentrated under reduced pressure to give the amino-ester LS3-8 as awhite solid (74.4 g, 99%).

¹H NMR (CDCl₃): δ 7.38-7.28 (5H, m, OCH₂ Ph), 7.10-7.06 (2H, m, Ph(4F)),6.96-6.90 (2H, m, Ph(4F)), 5.13 (2H, d, OCH ₂Ph), 3.76-3.71 (1H, t,CHCH₂Ph), (2H, dq, CHCH ₂Ph), 1.53 (2H, s, NH₂)

Step LS3-9. To a solution of LS3-8 (74.4 g, 0.27 mol, 1.0 eq) inanhydrous THF/CH₂Cl₂ (1:1, 1120 mL) were added Boc-(D)NMeAla-OH (LS3-C,57.1 g, 0.28 mol, 1.03 eq), 6-Cl-HOBt (46.2 g, 0.27 mol, 1.0 eq) andDIPEA (238 mL, 1.37 mol, 5.0 eq). The mixture was cooled to 0° C. andEDCI (57.6 g, 0.3 mol, 1.1 eq) was added. The mixture was stirred 1 h at4° C., allowed to warm to room temperature and stirred 18 h. The solventwas evaporated in vacuo and the residue dissolved in AcOEt (1000 mL).The organic phase was washed sequentially with an aqueous solution ofcitrate buffer (1 M, pH 3.5, 2×500 mL), H₂O (1×500 mL), an aqueoussolution of saturated NaHCO₃ (CAUTION: CO₂ is evolved, 2×500 mL) andbrine (1×500 mL). The organic phase was dried over MgSO₄ (180 g),filtered and concentrated under reduced pressure to give crude dipeptideLS3-9 as a yellow oil. (127 g, >100% crude yield).Step LS3-10. The oil LS3-9 was dissolved in 150 mL of dioxane, then asolution of 4 M HCl in dioxane (1360 mL, 20 eq) added and the mixturestirred for 1 h at room temperature. Reaction was monitored by TLC[AcOEt/Hexanes (3:2)]; R_(f)=baseline; detection: UV and ninhydrin]. Themixture was concentrated under reduced pressure and the resultingresidue co-evaporated with Et₂O (2×500 mL), then dried under vacuum. Thecrude LS3-10 was obtained as a slightly yellow solid (96 g, 89.7%). Thiswas dissolved in hot 95% EtOH (200 mL), then MTBE (900 mL) added. Themixture was cooled down to room temperature, then put in a freezer (−20°C.) for 18 h. The resulting crystals were collected by filtration andwashed with MTBE (2×200 mL), then dried under vacuum to give crystallinedipeptide hydrochloride LS3-10 (62 g, 64.5% recovery).

¹H NMR (DMSO-d₆): δ 9.31-9.28 (1H, d, C(O)NH), 7.38-7.26 (7H, m, Ph),7.09-7.04 (2H, m, Ph), 5.10 (2H, s, C(O)OCH ₂Ph), 4.65-4.57 (1H, m,CHCH₃), 3.76-3.69 (1H, d, CHCH₂Ph), 3.15-3.08 and 2.99-2.91 (CHCH ₂Ph),2.221 (3H, s, CH ₃NH₂+Cl⁻), 1.31-1.28 (3H, d, CHCH ₃).

¹³C NMR (DMSO-d₆): δ 171.33, 169.18, 137.63, 136.31, 129.92, 129.11,128.95, 128.83, 128.63, 127.30, 67.00, 56.57, 54.38, 36.98, 31.11,16.47.

LC/MS (Grad_A4): t_(R)=6.26 min

LC Chiral (Iso100B_(—)05): t_(R)=29.6 min. 97% UV

Melting point (uncorrected): 140-142° C.

Step LS3-11. To a solution of carboxylic acid LS3-6 (47.3 g, 87.6 mmol,1.0 eq) and dipeptide hydrochloride salt LS3-10 (36.2 g, 91.9 mmol, 1.05eq) in anhydrous THF/CH₂Cl₂ (1:1) (438 mL) at 0° C. were added DIPEA (92mL, 526 mmol, 6.0 eq) and HATU (34.9 g, 91.9 mmol, 1.05 eq). The mixturewas allowed to warm to room temperature and stirred 16-18 h. Reactionwas monitored by TLC [AcOEt/Hex (1:1); R_(f)=0.48; detection: UV andCMA] The mixture was concentrated under reduced pressure and the residuedissolved in AcOEt (250 mL). The organic phase was washed sequentiallywith an aqueous solution of citrate buffer (1 M, pH 3.5, 3×150 mL), H₂O(1×150 mL), an aqueous solution of saturated NaHCO₃ (2×150 mL) and brine(1×150 mL). The organic phase was dried over MgSO₄, filtered andconcentrated under reduced pressure. The residue was purified by flashchromatography [AcOEt:hexanes, gradient (10:90) to (50:50)] to giveLS3-11 as a white gummy solid (70.0 g, 90%).

LC/MS (Grad_A4): t_(R)=15.06 min

Step LS3-12. To a suspension of 10% Pd/C (13.8 g, 20% by weight) inAcOEt (150 mL) was added a solution of alkylated tripeptide LS3-11 (69.0g, 78.4 mmol, 1.0 eq) in AcOEt (375 mL), then hydrogen was bubbledthrough the solution for 16-18 h. The reaction was monitored by TLC[AcOEt/hexanes (1:1); R_(f)=0.22; detection: UV and CMA]. The mixturewas purged by nitrogen bubbling, filtered through a Celite pad andrinsed with AcOEt (3×). The combined filtrate and washings wereevaporated under reduced pressure to give LS3-12 as a white solid (51.4g, 100%).

LC/MS (Grad_A4): t_(R)=8.05 min

Step LS3-13. To LS3-12 (51.4 g, 78.4 mmol, 1.0 eq) was added a solutionof 3.0 M HCl in dioxane/H₂O (75:25, 525 mL, 1.57 mol, 20 eq) and themixture stirred at room temperature 1.5 h. The solvent was evaporatedunder vacuum, then the residue was azeotroped with toluene (3×) anddried under vacuum to give crude LS3-13 as an off-white solid (58.0g, >100% yield).

LC/MS (Grad_A4): t_(R)=5.38 min.

Step LS3-14. To a solution of macrocyclic precursor LS3-13 (78.4 mmolbased on LS3-12, 1.0 eq) in anhydrous THF (1.57 L, 50 mM) were addedDIPEA (68.0 mL, 392 mmol, 7.0 eq) and DEPBT (25.8 g, 86.2 mmol, 1.1 eq).The mixture was stirred at room temperature 16-18 h. The reaction wasmonitored by TLC [MeOH/AcOEt (1:9); R_(f)=0.38; detection: UV and CMA].At the end of the reaction, significant quantities of DIPEA salts werein suspension in the solution. Prior to evaporation, these salts werefiltered and washed with THF to avoid excessive bumping of the solutionduring evaporation. The solvent was evaporated under vacuum and theresidue taken up in an aqueous solution of Na₂CO₃ (1 M, 500 mL) andAcOEt (250 mL). The separated basic aqueous phase was extracted withAcOEt (2×250 mL). The combined organic phases were washed with brine(2×250 mL), dried over MgSO₄, filtered and evaporated under reducedpressure. The crude material so obtained was purified by flashchromatography [AcOEt:MeOH, gradient (100:0) to (90:10)] to givemacrocycle compound 298 as a pale yellow solid (35.0 g, 83%, 2 steps).

LC/MS (Grad_A4): t_(R)=6.19 min

Step LS3-15. To crude compound 298 (18.5 g, 34.4 mmol, 1.0 eq) inanhydrous EtOH (100 mL) was slowly added 1.25 M HCl in EtOH (41.2 mL,51.5 mmol, 1.5 eq). The mixture was stirred 5 min, cooled down to 0° C.and filtered while still cold. The white precipitate was washed withcold anhydrous EtOH (3×75 mL) and dried under vacuum to give compound298 hydrochloride as an amorphous white solid (15.3 g, 88% recovery,corrected).Purification of Compound 298. Amorphous compound 298 hydrochloride (14.2g, 24.7 mmol) was dissolved in a hot mixture of EtOH/H₂O (9:1, 215 mL).The solution was cooled down to room temperature and then placed in afreezer (−20° C.) for 16-18 h. The crystals were collected by filtrationand washed with cold anhydrous EtOH (3×75 mL) to give compound 298hydrochloride as a crystalline white solid (12.4 g, 86% recovery).Crystalline compound 298 hydrochloride (11.4 g, 19.9 mmol) was taken upin 1 M

Na₂CO₃/AcOEt (1:1, 200 mL) and stirred until complete dissolution of thesolid. The separated basic aqueous phase was extracted with AcOEt (2×50mL). The combined organic phases were washed with brine (1×50 mL), driedover MgSO₄, filtered and evaporated under vacuum. The oily residue wasdissolved in a minimum amount of AcOEt, then hexanes was added until awhite precipitate formed. The mixture was evaporated and dried undervacuum to give compound 298 as a white amorphous solid (11.1 g, 100%recovery).

LC/MS (Grad_A4): 6.18 min; Purity (UV/ELSD/CLND); 100/100/100.

This reaction sequence has been repeated in comparable yields startingfrom 1 kg Cbz-T33a, 518 g LS3-A and 1 kg LS3-B to yield over 400 g ofthe desired macrocyclic product compound 298 and/or the correspondingHCl salt form. Similar procedures can be applied for other compounds ofthe invention.

As an alternative, the t-butyl ester of Cpg (LS3-14), produced understandard conditions, can be utilized as was described in Step LS3-4 toprovide alkylated Cpg LS3-15 by reaction with Cbz-T33a. This, withoutprotection of the secondary amine on LS3-16 produced by standard aciddeprotection of the t-butyl ester of LS3-15, then undergoeschemoselective coupling with dipeptide LS3-10 to prepare LS3-17.Straightforward simultaneous hydrogenolysis of both Cbz and benzylprotecting groups then leads to intermediate LS3-13 in a more efficientapproach that avoids two steps.

Step LS3-17. To the hydrochloride salt of carboxylic acid LS3-16 (2.1 g,4.41 mmol, 1.0 eq) and LS3-10 (1.7 g, 4.59 mmol, 1.05 eq) in anhydrousTHF/CH₂Cl₂ (1:1, 22 mL) at 0° C. were added DIPEA (5.3 mL, 30.6 mmol,7.0 eq) and HATU (1.7 g, 4.59 mmol, 1.05 eq). The mixture was allowed towarm to room temperature and stirred 16-18 h. The reaction was monitoredby LC-MS. The mixture was concentrated under reduced pressure and theresidue dissolved in AcOEt (150 mL). The organic phase was washedsequentially with an aqueous solution of citrate buffer (1 M, pH 3.5,3×25 mL), H₂O (1×25 mL), an aqueous solution of saturated NaHCO₃ (2×25mL) and brine (1×25 mL). The organic phase was dried over MgSO₄,filtered and concentrated under vacuum to give LS3-17 as a white solid(3.5 g, >100% crude yield).

LC/MS (Grad_A4): t_(R)=12.09 min.

Step LS3-18. To a suspension of 10% Pd/C (596 mg, 20% by weight) in 95%EtOH (10 mL) was added a solution of alkylated tripeptide LS3-17 (3.0 g,3.82 mmol, 1.0 eq) in AcOEt (15 mL) and hydrogen bubbled through thesolution for 2 h. The mixture was then stirred under a hydrogenatmosphere for 16-18 h. The reaction was monitored by TLC [100% AcOEt;R_(f)=Baseline; detection: UV and CMA]. The mixture was purged bynitrogen bubbling, filtered through a Celite pad and rinsed with 95%EtOH (3×20 mL). The combined filtrate and rinses were evaporated underreduced pressure to give LS3-13 as a white solid (2.0 g, 94%).

LC/MS (Grad_A4): t_(R)=5.40 min.

B. Biological Results

1. Radioligand Binding Assay on Ghrelin Receptor (human clone, hGHS-R1a)

Objective

-   -   1. To demonstrate that compound 298 has a direct, high affinity        interaction with hGHS-R1a        Key Aspects of Method    -   1. Binding performed on membranes prepared from HEK293        expressing the transfected, cloned human ghrelin receptor        (hGHS-R1a).    -   2. [¹²⁵I]Ghrelin was used as the radioligand for displacement        (K_(d)=0.01 nM, test concentration=0.007 nM).    -   3. Ghrelin (unlabeled, 1 μM) was used to determine non-specific        binding.    -   4. Compound 298 tested in duplicate samples over an 11-point        concentration curve.        Results

Compound 298 binding to hGHS-R1a has been run multiple times. Arepresentative binding inhibition curve as shown in FIG. 10 demonstratesthat compound 298 binds competitively, reversibly, and with highaffinity to hGHS-R1a.

2. Cell-based, Functional Assays on Ghrelin Receptor (Human Clone,hGHS-R1a)

Objectives

-   -   1. To demonstrate that compound 298 is a full agonist at        hGHS-R1a.    -   2. To measure the potency of compound 298 agonist activity at        hGHS-R1a.        Key Aspects of Method    -   1. Assay performed on CHO-K1 cells expressing the transfected,        cloned human ghrelin receptor (hGHS-R1a) and G_(α16)    -   2. Suspended cells incubated O/N with coelenterazine.    -   3. Stimulation of hGHS-R1a activates G_(α16), causing        intercellular Ca2+ release which ultimately leads to the        oxidation of coelenterazine and the emission of a quantitative        luminescent signal.    -   4. Ghrelin was used as the positive control.    -   5. Compound 298 tested in duplicate samples over an 8-point        concentration curve.        Results

Compound 298 activates hGHS-R1a with an EC₅₀=25 nM as shown in FIG. 11.Compound 298 is a full agonist based on its similar, maximal efficacy tothe ghrelin peptide (positive control).

3. Compound 298 (i.v.) Effect on Growth Hormone (GH) Release inConscious, Freely-Moving Rats.

Ghrelin (and analogues thereof) is known to potently stimulate GHrelease from the pituitary in various species including rat followingintravenous dosing.

Objectives

-   -   1. To determine whether compound 298 stimulates GH release in        rat.    -   2. To determine whether compound 298 modulates ghrelin-induced        GH release in rat.        Method    -   1. Model adapted from Tannenbaum et al. (2003), Endocrinology        144:967-974.    -   2. Rats implanted with chronic, intravenous (i.v.) cannulae.    -   3. Rats allowed to move freely even while dosing drug or        sampling blood to minimize stress-induced changes in GH release.    -   4. Compound 298 administered at GH peak and trough levels to        measure:        -   a. Stimulatory effect, if any, on GH release; and        -   b. Whether any stimulatory effect is sustained with repeated            dosing.    -   5. Blood samples are drawn at defined, 15-minute intervals        throughout the test day and growth hormone (GH) measured        directly by radioimmunoassay.    -   6. Compound 298 tested at 3, 30, 300, 1000 μg/kg (i.v.,        N=5-6/rats per group).    -   7. Ghrelin (positive control) tested at 5 μg (i.v.).        Results

Compound 298 at doses up to 1000 μg/kg causes no significant differencein pulsatile GH release in comparison to vehicle controls (FIG. 12A for300 μg/kg). Ghrelin at a dose of 5 μg causes a significant increase inGH release when dosed at both peak and trough levels (positive control).Compound 298 dosed 10 min. prior to ghrelin neither inhibits noraugments ghrelin-induced GH release (FIG. 12B). As a secondary indicatorof GH release, the effects of compound 298 on the levels of IGF-1 werealso examined at the 1000 μg/kg dose. No changes in IGF-1 levels upontreatment with compound 298 were observed.

4. Compound 298 Effect on hGHS-R1a Receptor Desensitization

G-protein coupled receptors can undergo receptor desensitization uponagonist stimulation, where the degree of receptor desensitization ispartly characteristic of the agonist. Lesser receptor desensitization isdesirable because this correlates with lesser development of tolerancewith chronic use of drug. This factor, among others, has been implicatedin the poor clinical performance of GHS.

Objective

-   -   1. To determine the extent to which Compound 298 causes        desensitization of the ghrelin receptor (human clone, hGHS-R1a).        Method    -   1. Studies by FLIPR (Fluorometric Imaging Plate Reader,        Molecular Devices).    -   2. Assay performed on HEK293 cells expressing hGHS-R1a.    -   3. Compound 298 agonist potency was measured using duplicate        samples over a 12-point concentration curve; EC₅₀ for compound        298 established.    -   4. In a separate experiment, cells expressing hGHS-R1a are        exposed to a range of concentrations of compound 298 (1, 10,        100, 1000 nM) for 3 minutes. Compound 298 washed out, then cells        treated with a concentration of ghrelin (EC₁₀₀) that elicits        maximal stimulation at non-desensitized receptors.    -   5. A DC₅₀ value is calculated. The DC₅₀ value is defined as the        pre-treatment concentration of compound 298 that desensitizes        the ghrelin (EC₁₀₀) response by 50%.        Results

Compound 298 is a full agonist (EC₅₀=5 nM; FIG. 13A). Increasingpre-treatment concentrations of compound 298 desensitize the maximalresponse to EC₁₀₀ ghrelin (DC₅₀=32 nM; FIG. 13B). The DC₅₀ valueis >6-fold less potent than the EC₅₀ value, thus compound 298 stimulatesthe receptor more potently than it desensitizes the receptor. Compound298 desensitizes the receptor ˜10-fold less potently than other ghrelinagonists (i.e. ghrelin peptide and the GHS capromorelin [Pfizer]; FIG.13C).

Compound 298 has a favorable desensitization profile since it (1)stimulates the receptor 6-fold more potently that it desensitizes thereceptor and (2) elicits desensitization at a 10-fold lower potency thanthe endogenous ligand (i.e. ghrelin) and alternate, small-moleculeghrelin agonists. Accordingly, compound 298 may elicit less tolerancethan alternate ghrelin agonists with chronic dosing.

5. Compound 298 Effect on Gastric Emptying of a Solid Meal in Naïve Rat

Objectives

-   -   1. To ascertain data for compound 298 as a prokinetic agent with        potent effects on gastric emptying, a model for gastroparesis.        Methods    -   1. Overnight-fasted rats (male, Wistar, ˜200 g, N=5/group) were        given a meal of methylcellulose (2%) by intragastric gavage. The        meal was labeled with phenol red (0.05%).    -   2. Test articles (i.e. vehicle, compound 298, metoclopramide,        etc.) were administered by intravenous injection immediately        after meal.    -   3. Animals were sacrificed 15 minutes later; the stomach was        immediately removed and homogenized in 0.1 N NaOH and        centrifuged.    -   4. Total phenol red remaining in the stomach was quantified by a        calorimetric method at 560 nm.    -   5. A >30% increase in gastric emptying, detected based on the        phenol red concentration in comparison to the control group, is        considered significant.        Results

Metoclopramide (marketed gastroparesis product), ghrelin and GHRP-6(reference peptide agonists at hGHS-R1a) all demonstrated significantgastric emptying (FIG. 14A). Compound 298 caused significant gastricemptying in a dose-dependent manner with ˜100-fold superior potency tometoclopramide (FIG. 14B). Compound 298 potently stimulated gastricemptying of a solid meal in naïve rats with a 100-fold superior potencyto metoclopramide, a currently used drug with prokinetic activity.

6. Effect of Compound 298 in the Treatment of Post-operative Ileus inRat

Objective

To measure the therapeutic utility of compound 298 in a rat model ofpost-operative ileus (POI).

Methods

-   -   1. Model adapted from Kälff et al. (1998), Ann Surg 228:652-63.    -   2. Rats (male, Sprague-Dawley, 250-300 g) were implanted with        jugular vein catheters to accommodate dosing of test articles.    -   3. Rats were fasted O/N, anesthetized with isofluorane and        subjected to abdominal surgery.    -   4. Following an abdominal incision, the small intestine caecum        and large intestine were eviscerated for a period of 15 min and        kept moist with saline.    -   5. A “running of the bowel” was performed, a clinically-relevant        manipulation of the intestines characterized by first pinching        the upper small intestine and continuing this manipulation down        through the large intestine.    -   6. Rats are allowed a 15 min recovery beginning after the        disappearance of any effects of the isofluorane anesthesia.    -   7. Rats are dosed with vehicle or compound 298 (30, 100, or 300        μg/kg, i.v., N=6/gp) followed by intragastric gavage of ^(99m)Tc        methylcellulose (2%) meal.    -   8. After 15 min, the rats were euthanized and the stomach and        consecutive 10 cm segments of the intestine were isolated.        Radioactivity (^(99m)Tc) in each tissue isolate was measured as        a means of measuring the transit of the meal.        Results

In FIG. 15, the distribution of the bars indicates the distribution ofthe meal in the stomach (‘ST’) and consecutive 10 cm segments of thesmall intestine at 15 min post-oral gavage. Abdominal surgery coupledwith a running of the bowel caused a significant ileus in rats asdetermined by comparison of the naïve (i.e. unoperated) and POItreatment groups. Compound 298 significantly increased gastric emptyingand intestinal transit at test concentrations of 100 and 300 μg/kg(i.v.). The data corresponding to the 100 μg/kg dose is presented inFIG. 15. At 100 μg/kg (i.v.), compound 298 significantly promoted GItransit by 2.7× as measured by the geometric center of the meal incomparison to the POI+vehicle treatment group. Compound 298significantly improved gastric emptying and intestinal transit in ratswith post-operative ileus. Compound 298 can effectively treat anexisting, post-surgical ileus; thus, prophylactic use prior to surgeryis not required as is the case for opioid antagonists in clinicaldevelopment.

7. The Effect of Compounds of the Invention on Gastric Emptying andGastrointestinal Transit in a Model of Opioid-Delayed Gastric Emptying

Opioid analgesics, such as morphine, are well known to delaygastrointestinal transit which is an important side-effect for thisclass of drugs. The clinical term for this syndrome is opioid boweldysfunction (OBD). Importantly, patients recovering from abdominalsurgery experience post-operative ileus that is further exacerbated byconcomitant opioid therapy for post-surgical pain.

Objective

-   1. To determine whether compounds of the invention may have    therapeutic utility in the treatment of opioOBD.    Methods-   1. Rats (male, Sprague-Dawley, 250-300 g) are implanted with jugular    vein catheters to accommodate dosing of test articles.-   2. Overnight-fasted rats are administered morphine (3 mg/kg s.c.).-   3. After 30 min, rats are to be dosed with vehicle or compound 298    (300 or 1000 μg/kg, i.v., n=4-to-6/gp) followed by intragastric    gavage of ^(99m)Tc methylcellulose (2%) meal.-   4. After 15 min, the rats are euthanized and the stomach and    consecutive 10 cm segments of the intestine are isolated.    Radioactivity (^(99m)Tc) in each tissue isolate is measured as a    means of measuring the transit of the meal.    Results

Morphine (3 mg/kg, s.c.) significantly delayed gastric emptying andintestinal transit in rats (FIG. 16A). Opioid-delayed gastrointestinaltransit was effectively reversed in a dose-dependent manner by treatmentwith compound 298 (iv.) (FIG. 16B).

8. Metabolic Stability in Human Plasma

Drugs are susceptible to enzymatic degradation in plasma through theaction of various proteinases and esterases. Thus, plasma stability isoften performed as a metabolic screen in the early phases of drugdiscovery. The aim of this study is to measure the metabolic stabilityof compounds of the invention in human plasma.

Experimental Method

The stability of compound 298 in human plasma at 37° C. has beenmeasured at 2 and 24 h. Two forms of compound 298 have been studied:free amine and corresponding HCl salt. Also, the stability of compound298 has been established in plasma alone and in plasma buffered withphosphate-buffered saline (PBS) where the ratio of plasma to phosphatebuffer (pH 7.0) is 20:1. Assays were both performed and analyzed intriplicate samples. Compound 298 was extracted from plasma matrix usingan SPE technique (Oasis MCX cartridge). Sample analysis is done usingLC-MS in APCI⁺ mode. The level of compound 298 in plasma samples iscompared to the level of compound 298 in a spiked sample stored at −60°C. from the same pool of plasma. Results are presented as a percentrecovery of compound 298.

TABLE 8 Percent Recovery of Compound 298 Following Incubation in HumanPlasma (37° C.). Free Amine + Free amine PBS HCl Salt HCl Salt + PBS 224 2 24 2 24 2 24 Hours Hours Hours Hours Hours Hours Hours HoursTriplicates (%) (%) (%) (%) (%) (%) (%) (%) Assay #1 101.0 105.5 98.397.9 100.2 96.6 102.9 97.8 Assay #2 100.3 95.6 100.4 100.8 99.1 104.397.4 101.9 Assay #3 101.3 100.9 98.3 101.9 101.6 102.3 99.4 98.5 Mean100.9 100.7 99.0 100.2 100.3 101.1 99.9 99.4 Standard 0.5 4.9 1.2 2.11.3 4.0 2.7 2.2 Deviation RSD 0.5 4.9 1.3 2.1 1.3 4.0 2.7 2.2

As shown in Table 8, compound 298 is stable in human plasma at 37° C.for at least 24 hours independent of compound form (i.e. free amine orsalt) or whether or not the plasma samples are pH buffered with PBS.

9. Compound 298 Interaction Profile at Nine Human Cytochrome P450 EnzymeSubtypes

Compound 298 (0.0457 to 100 μM) has minimal inhibitory activity at allcyp450 enzymes tested, except cyp3A4, and has moderate inhibitoryactivity at cyp3A4. The inhibitory activity observed for compound 298 atcyp3A4 was not anticipated to be physiologically relevant based on thelow doses of compound 298 required for therapeutic activity. Also, therewas no indication that compound 298 would undergo a drug-druginteraction with opioid analgesics that may be co-administered to POIpatients.

10. Compound 298 Profile in hERG Channel Inhibition

Compound 298 (1, 10 μM) had no significant effect on hERG channelfunction in comparison to vehicle (0.1% DMSO) controls. E-4031 (positivecontrol) completely inhibited hERG channel currents at 500 nM.

Example 5 Gastroparesis Animal Model

High caloric meals are well known to impede gastric emptying. Thisobservation has recently been exploited by Megens, A. A.; et al.(unpublished) to develop a rat model for delayed gastric emptying asexperienced in gastroparesis.

Materials

-   1. Wistar rats, male, 200-250 g-   2. Chocolate test meal: 2 mL Clinutren ISO® (1.0 kcal/mL, Nestle S    A, Vevey Switzerland)    Method

The test meal is given to the subjects by oral gavage at time=0. After60 min, the subjects are sacrificed, the stomachs excised and thecontents weighed. Untreated animals experienced a significant delay ingastric emptying as denoted by the higher residual stomach content.

Test compounds were administered intravenously as aqueous solutions, orsolutions in normal saline, at time=0 at three dose levels (0.08 mg/kg;0.30-0.31 mg/kg, 1.25 mg/kg). When necessary, for example compounds 21,299 and 415, 10% cyclodextrin (CD) was added to solubilize the material.Test compounds examined utilizing subcutaneous injection areadministered at time=−30 min. Four to five (4-5) rats were tested pergroup, except in the case of the cyclodextrin control in which ten (10)rats comprised the group.

Results are reported as percentage relative to the stomach weight forinjection only of solvent as a control as shown in FIGS. 17A and 17B andillustrate the gastric emptying capability of the compounds of thepresent invention. These results are applicable for the utility of thesecompounds for the prevention and/or treatment of gastroparesis and/orpostoperative ileus.

The foregoing is illustrative of the present invention, and is not to beconstrued as limiting thereof. The invention is defined by the followingclaims, with equivalents of the claims to be included therein.

1. A pharmaceutically acceptable salt of a macrocyclic compound havingthe following structure:


2. The pharmaceutically acceptable salt of claim 1, wherein the salt isan amorphous form.
 3. The pharmaceutically acceptable salt of claim 1,wherein the salt is a crystalline form.
 4. The pharmaceuticallyacceptable salt of claim 1, wherein the salt is a hydrochloride,hydrobromide or hydroiodide salt.
 5. The pharmaceutically acceptablesalt of claim 1, wherein the salt is a hydrochloride salt.
 6. A processfor preparing a pharmaceutically acceptable salt of a compound havingthe following structure:

The process comprising: (a) dissolving a macrocyclic compound having thefollowing structure:

in a solution of an alcohol to form solution A; (b) adding an acid tosolution A to form acidified solution A; (c) optionally coolingacidified solution A; and (d) separating a precipitated salt fromacidified solution A; (e) dissolving the precipitated salt from (d) in ahot mixture of an alcohol and water to form solution C; (f) coolingsolution C; and (g) separating a precipitated salt from solution C. 7.The process of claim 6, wherein the alcohol is ethanol.
 8. The processof claim 6, wherein the acid is hydrochloric acid.
 9. The process ofclaim 6, wherein the precipitated salt is an amorphous form.
 10. Theprocess of claim 6, wherein the precipitated salt is a hydrochloridesalt.
 11. The process of claim 6, wherein the precipitated salt fromsolution C is a crystalline form.
 12. A pharmaceutical compositioncomprising: (a) a pharmaceutically acceptable salt of claim 1; and (b) apharmaceutically acceptable carrier, excipient or diluent.
 13. Thepharmaceutical composition of claim 12 further comprising a growthhormone secretagogue.
 14. The pharmaceutical composition of claim 13,wherein the growth hormone secretagogue is hexarelin, GHRP-1, GHRP-2,GHRP-6, ipamorelin, MK-0677, NN703, capromorelin, G7039, G7134, G7203,G7502, SM-130686, RC-1291, L-692429, L-692587, L-739943, L-163255,L-163540, L-163833, L-166446, CP-424391, EP-51389, LY-444711,NNC-26-0235, NNC-26-0323, NNC-26-0610, NNC-26-0722, NNC-26-1089,NNC-26-1136, NNC-26-1137, NNC-26-1187, NNC-26-1291, growth hormonereleasing factor, IGF-I or IGF-II.